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Emmerzaal J, Vets N, Devoogdt N, Smeets A, De Groef A, De Baets L. Upper-Limb Movement Quality before and after Surgery in Women with Breast Cancer: An Exploratory Study. SENSORS (BASEL, SWITZERLAND) 2024; 24:3472. [PMID: 38894264 PMCID: PMC11175096 DOI: 10.3390/s24113472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 05/13/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024]
Abstract
(1) Background: This study aimed to describe upper-limb (UL) movement quality parameters in women after breast cancer surgery and to explore their clinical relevance in relation to post-surgical pain and disability. (2) Methods: UL movement quality was assessed in 30 women before and 3 weeks after surgery for breast cancer. Via accelerometer data captured from a sensor located at the distal end of the forearm on the operated side, various movement quality parameters (local dynamic stability, movement predictability, movement smoothness, movement symmetry, and movement variability) were investigated while women performed a cyclic, weighted reaching task. At both test moments, the Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH) questionnaire was filled out to assess UL disability and pain severity. (3) Results: No significant differences in movement quality parameters were found between the pre-surgical and post-surgical time points. No significant correlations between post-operative UL disability or pain severity and movement quality were found. (4) Conclusions: From this study sample, no apparent clinically relevant movement quality parameters could be derived for a cyclic, weighted reaching task. This suggests that the search for an easy-to-use, quantitative analysis tool for UL qualitative functioning to be used in research and clinical practice should continue.
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Affiliation(s)
- Jill Emmerzaal
- Department of Rehabilitation Sciences, KU Leuven, 3000 Leuven, Belgium; (J.E.)
| | - Nieke Vets
- Department of Rehabilitation Sciences, KU Leuven, 3000 Leuven, Belgium; (J.E.)
- CarEdOn Research Group, 3000 Leuven, Belgium
| | - Nele Devoogdt
- Department of Rehabilitation Sciences, KU Leuven, 3000 Leuven, Belgium; (J.E.)
- CarEdOn Research Group, 3000 Leuven, Belgium
- Department of Vascular Surgery and Department of Physical Medicine and Rehabilitation, Centre for Lymphoedema, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Ann Smeets
- Department of Oncology, KU Leuven, 3000 Leuven, Belgium
- Department of Surgical Oncology, University Hospitals Leuven, 3000 Leuven, Belgium
| | - An De Groef
- Department of Rehabilitation Sciences, KU Leuven, 3000 Leuven, Belgium; (J.E.)
- CarEdOn Research Group, 3000 Leuven, Belgium
- MOVANT Research Group, Department of Rehabilitation Sciences, University of Antwerp, 2000 Antwerp, Belgium
- Pain in Motion International Research Group, 1090 Brussels, Belgium
| | - Liesbet De Baets
- Pain in Motion International Research Group, 1090 Brussels, Belgium
- Pain in Motion (PAIN) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, 1090 Brussels, Belgium
- Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital Brussels, 1090 Brussels, Belgium
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Sakaguchi T, Gunjotikar S, Tanaka M, Komatsubara T, Latka K, Ekade SJ, Prabhu SP, Takamatsu K, Yasuda Y, Nakagawa M. Evaluation and Rehabilitation after Adult Lumbar Spine Surgery. J Clin Med 2024; 13:2915. [PMID: 38792457 PMCID: PMC11122457 DOI: 10.3390/jcm13102915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/07/2024] [Accepted: 05/14/2024] [Indexed: 05/26/2024] Open
Abstract
Purpose: With an increase in the proportion of elderly patients, the global burden of spinal disease is on the rise. This is gradually expected to increase the number of surgical procedures all over the world in the near future. As we know, rehabilitation following spine surgery is critical for optimal recovery. However, the current literature lacks consensus regarding the appropriate post-operative rehabilitation protocol. The purpose of this review is to evaluate the optimal protocol for rehabilitation after lumbar spine surgery in adults. Materials and Methods: The goals of rehabilitation after lumbar spine surgery are to improve physical and psychosocial function and may include multiple modalities such as physical therapy, cognitive behavioral therapy, specialized instruments, and instructions to be followed during activities of daily living. In recent years, not only are a greater number of spine surgeries being performed, but various different techniques of lumbar spine surgery and spinal fusion have also emerged. (1) Our review summarizes post-operative rehabilitation under the following headings-1. Historical aspects, 2. Subjective functional outcomes, and (3) Actual rehabilitation measures, including balance. Results: Physical therapy programs need to be patient-specific and surgery-specific, such that they consider patient-reported outcome measures and take into consideration the technique of spinal fusion used and the muscle groups involved in these surgeries. By doing so, it is possible to assess the level of functional impairment and then specifically target the strengthening of those muscle groups affected by surgery whilst also improving impaired balance and allowing a return to daily activities. Conclusions: Rehabilitation is a multi-faceted journey to restore mobility, function, and quality of life. The current rehabilitation practice focuses on muscle strengthening, but the importance of spinal balance is less elaborated. We thus equally emphasize muscle strengthening and balance improvement post-lumbar spine surgery.
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Affiliation(s)
- Tomoyoshi Sakaguchi
- Department of Rehabilitation, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, Japan; (T.S.); (K.T.); (Y.Y.); (M.N.)
| | - Sharvari Gunjotikar
- Department of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, Japan; (S.G.); (T.K.); (K.L.); (S.J.E.); (S.P.P.)
| | - Masato Tanaka
- Department of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, Japan; (S.G.); (T.K.); (K.L.); (S.J.E.); (S.P.P.)
| | - Tadashi Komatsubara
- Department of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, Japan; (S.G.); (T.K.); (K.L.); (S.J.E.); (S.P.P.)
| | - Kajetan Latka
- Department of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, Japan; (S.G.); (T.K.); (K.L.); (S.J.E.); (S.P.P.)
| | - Shashank J. Ekade
- Department of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, Japan; (S.G.); (T.K.); (K.L.); (S.J.E.); (S.P.P.)
| | - Shrinivas P. Prabhu
- Department of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, Japan; (S.G.); (T.K.); (K.L.); (S.J.E.); (S.P.P.)
| | - Kazuhiko Takamatsu
- Department of Rehabilitation, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, Japan; (T.S.); (K.T.); (Y.Y.); (M.N.)
| | - Yosuke Yasuda
- Department of Rehabilitation, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, Japan; (T.S.); (K.T.); (Y.Y.); (M.N.)
| | - Masami Nakagawa
- Department of Rehabilitation, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, Japan; (T.S.); (K.T.); (Y.Y.); (M.N.)
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Miqueleiz U, Aguado-Jimenez R, Lecumberri P, Garcia-Tabar I, Gorostiaga EM. Reliability of Xsens inertial measurement unit in measuring trunk accelerations: a sex-based differences study during incremental treadmill running. Front Sports Act Living 2024; 6:1357353. [PMID: 38600906 PMCID: PMC11004309 DOI: 10.3389/fspor.2024.1357353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 03/11/2024] [Indexed: 04/12/2024] Open
Abstract
Introduction Inertial measurement units (IMUs) are utilized to measure trunk acceleration variables related to both running performances and rehabilitation purposes. This study examined both the reliability and sex-based differences of these variables during an incremental treadmill running test. Methods Eighteen endurance runners performed a test-retest on different days, and 30 runners (15 females) were recruited to analyze sex-based differences. Mediolateral (ML) and vertical (VT) trunk displacement and root mean square (RMS) accelerations were analyzed at 9, 15, and 21 km·h-1. Results No significant differences were found between test-retests [effect size (ES)<0.50)]. Higher intraclass correlation coefficients (ICCs) were found in the trunk displacement (0.85-0.96) compared to the RMS-based variables (0.71-0.94). Male runners showed greater VT displacement (ES = 0.90-1.0), while female runners displayed greater ML displacement, RMS ML and anteroposterior (AP), and resultant euclidean scalar (RES) (ES = 0.83-1.9). Discussion The IMU was found reliable for the analysis of the studied trunk acceleration-based variables. This is the first study that reports different results concerning acceleration (RMS) and trunk displacement variables for a same axis in the analysis of sex-based differences.
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Affiliation(s)
- Unai Miqueleiz
- Department of Health Sciences, Public University of Navarra, Pamplona, Spain
- Studies, Research and Sports Medicine Centre (CEIMD), Government of Navarre, Pamplona, Spain
| | | | - Pablo Lecumberri
- Department of Mathematics, Public University of Navarre, Pamplona, Spain
| | - Ibai Garcia-Tabar
- Society, Sports and Physical Exercise Research Group (GIKAFIT), Department of Physical Education and Sport, Faculty of Education and Sport, University of the Basque Country, Vitoria-Gasteiz, Spain
| | - Esteban M. Gorostiaga
- Studies, Research and Sports Medicine Centre (CEIMD), Government of Navarre, Pamplona, Spain
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Sakaguchi T, Sake N, Tanaka M, Fujiwara Y, Arataki S, Taoka T, Kodama Y, Takamatsu K, Yasuda Y, Nakagawa M, Utsunomiya K, Tomiyama H. Use of a Triaxial Accelerometer to Measure Changes in Gait Sway and Related Motor Function after Corrective Spinal Fusion Surgery for Adult Spinal Deformity. J Clin Med 2024; 13:1923. [PMID: 38610688 PMCID: PMC11012576 DOI: 10.3390/jcm13071923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/14/2024] [Accepted: 03/22/2024] [Indexed: 04/14/2024] Open
Abstract
Background: Adult spinal deformity is a complex condition that causes lower back pain, causing spinal imbalance and discomfort in activities of daily life. After corrective spinal surgery, patients' gait and balance abilities might not revert to normalcy and they might be at increased risk of falling. Therefore, early evaluation of such a risk is imperative to prevent further complications such as a fall, or even worse, fractures in post-surgery ASD patients. However, there has been no report of an investigation of such early changes in gait sway before and after ASD surgery. This is a prospective to investigate changes in gait sway before and following ASD surgery, using accelerometers, and also to examine motor function related to postoperative gait sway. Methods: Twenty patients were included who underwent corrective surgery as treatment for ASD, from October 2019 to January 2023. Measurement parameters included a 10 m walking test and the timed up-and-go test (TUG), gait sway was evaluated using accelerometers (root mean square; RMS), and hip flexion and knee extension muscle strength were tested. RMS included RMS vertical: RMSV; RMS anterior posterior: RMSAP; RMS medial lateral: RMSML. The radiographic spinopelvic parameters were also evaluated preoperatively and postoperatively. p < 0.05 was noted as remarkably significant. Results: Preoperative and postoperative RMSV were 1.07 ± 0.6 and 1.31 ± 0.8, respectively (p < 0.05). RMSML significantly decreased from 0.33 ± 0.2 to 0.19 ± 0.1 postoperatively (p < 0.01). However, RMSAP did not change postoperatively (0.20 ± 0.2 vs. 0.14 ± 0.1, p > 0.05). Patients' one-month postoperative hip flexor muscle strength became significantly weaker (0.16 ± 0.04 vs. 0.10 ± 0.03 kgf/kg, p = 0.002), but TUG was maintained (11.6 ± 4.2 vs. 11.7 s, p = 0.305). RMSV was negatively correlated with quadriceps muscle strength and positively with TUG. RMSAP was negatively correlated with quadriceps muscle strength. All spinopelvic parameters became normal range after surgery. Conclusions: After corrective spinal fusion for ASD patients, the gait pattern improved significantly. Iliopsoas (hip flexor) and quadriceps femoris (knee extensor) muscles may play important roles for gait anterolateral and vertical swing, respectively.
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Affiliation(s)
- Tomoyoshi Sakaguchi
- Department of Rehabilitation, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, Japan; (T.S.); (K.T.); (Y.Y.); (M.N.); (K.U.)
| | - Naveen Sake
- Department of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, Japan; (N.S.); (Y.F.); (S.A.); (T.T.); (Y.K.)
| | - Masato Tanaka
- Department of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, Japan; (N.S.); (Y.F.); (S.A.); (T.T.); (Y.K.)
| | - Yoshihiro Fujiwara
- Department of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, Japan; (N.S.); (Y.F.); (S.A.); (T.T.); (Y.K.)
| | - Shinya Arataki
- Department of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, Japan; (N.S.); (Y.F.); (S.A.); (T.T.); (Y.K.)
| | - Takuya Taoka
- Department of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, Japan; (N.S.); (Y.F.); (S.A.); (T.T.); (Y.K.)
| | - Yuya Kodama
- Department of Orthopedic Surgery, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, Japan; (N.S.); (Y.F.); (S.A.); (T.T.); (Y.K.)
| | - Kazuhiko Takamatsu
- Department of Rehabilitation, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, Japan; (T.S.); (K.T.); (Y.Y.); (M.N.); (K.U.)
| | - Yosuke Yasuda
- Department of Rehabilitation, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, Japan; (T.S.); (K.T.); (Y.Y.); (M.N.); (K.U.)
| | - Masami Nakagawa
- Department of Rehabilitation, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, Japan; (T.S.); (K.T.); (Y.Y.); (M.N.); (K.U.)
| | - Kayo Utsunomiya
- Department of Rehabilitation, Okayama Rosai Hospital, 1-10-25 Chikkomidorimachi, Minami Ward Okayama, Okayama 702-8055, Japan; (T.S.); (K.T.); (Y.Y.); (M.N.); (K.U.)
| | - Hiroki Tomiyama
- Hashimoto Artificial Limb Manufacture Co., Ltd., 32-13 Urayasunishimachi, Minami Ward, Okayama 702-8025, Japan;
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Todaka R, Kajiyama T, Kariu N, Anan M. Longitudinal changes in trunk acceleration and their relationship with gait parameters in post-stroke hemiplegic patients. Hum Mov Sci 2024; 93:103176. [PMID: 38160497 DOI: 10.1016/j.humov.2023.103176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 12/21/2023] [Accepted: 12/23/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE The purpose of this study was to examine the longitudinal changes in trunk acceleration, gait speed, and paretic leg motion in patients with post-stroke hemiparesis, the relationships between variables at each time point, and whether initial trunk acceleration and gait parameters were related to gait speed 2 months later. METHODS Gait was assessed monthly in patients who could walk under supervision after stroke onset. Gait parameters, including gait speed and trailing limb angle (TLA), were measured. Trunk acceleration was quantified using acceleration root mean square (RMS) and stride regularity (SR) indices. RESULTS This study found statistically significant longitudinal changes in gait speed (p < .001), acceleration RMS of the total axes (p < .001), and SR of the vertical axes (p < .001). Gait speed correlated significantly with the acceleration RMS of the mediolateral (r = -0.815 to -0.901), vertical (r = -0.541 to -0.747), and anteroposterior (r = -0.718 to -0.829) axes, as well as the SR of the vertical axes (r = 0.558 to 0.724) at all time points from T0 to T2. For the TLA, only the acceleration RMS of the mediolateral axis correlated significantly over the entire study period (r = -0.530 to -0.724). In addition, initial TLA correlated significantly with gait speed after 2 months (r = -0.572). CONCLUSION This study showed that assessing trunk acceleration helps estimate the improvement in gait status in patients with post-stroke hemiparesis. The magnitude and regularity of trunk acceleration varied longitudinally and were related to gait speed and paretic leg motion at each time point; however, they could not predict future changes in gait speed.
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Affiliation(s)
- Ryosuke Todaka
- Graduate School of Welfare and Health Science, Oita University, 700, Dannoharu, Oita-shi, Oita 870-1192, Japan; Department of Rehabilitation, Beppu Rehabilitation Center, 1026-10, tsurumi, Beppu-shi, Oita 874-8611, Japan
| | - Tetsu Kajiyama
- Department of Rehabilitation, Beppu Rehabilitation Center, 1026-10, tsurumi, Beppu-shi, Oita 874-8611, Japan
| | - Naoya Kariu
- Department of Rehabilitation, Beppu Rehabilitation Center, 1026-10, tsurumi, Beppu-shi, Oita 874-8611, Japan
| | - Masaya Anan
- Physical Therapy Course, Faculty of Welfare and Health Science, Oita University, 700, Dannoharu, Oita-shi, Oita 870-1192, Japan.
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Shiwa T, Kawabata Y, Ishii T, Anan M. Effect of heel lift insertion on gait function in a patient with total hip arthroplasty with patient-perceived leg length difference: a case report. J Phys Ther Sci 2024; 36:81-86. [PMID: 38304151 PMCID: PMC10830159 DOI: 10.1589/jpts.36.81] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 11/02/2023] [Indexed: 02/03/2024] Open
Abstract
[Purpose] The effect of heel lift insertion on gait in patients who have undergone total hip arthroplasty (THA) with patient-perceived leg length difference is seldom referenced in the literature. We used an AB design to investigate the alterations of gait function before and after inserting a heel lift on the non-operative side. [Participant and Methods] The participant had a patient-perceived leg length difference after THA and presented with gait disturbance. The survey phase was 10 days (phase A: normal physiotherapy for five days, and phase B: normal physiotherapy and heel lift insertion for another five days) from the 17th day following THA. The ambulatory task was conducted at a self-determined, comfortable pace and objectively assessed using an inertial sensor. [Results] The insertion of a heel lift partially improved the gait symmetry and the ratio of lumbar acceleration in three directions; it also corrected the patient-perceived leg length difference. [Conclusion] An investigation was carried out to examine the impact of a heel lift on gait in a single case of THA with patient-reported leg length difference. The application of a heel lift may enhance the relationship between the patient-perceived leg length difference, gait symmetry, and the ratio of lumbar acceleration in three dimensions.
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Affiliation(s)
- Toru Shiwa
- Graduate School of Welfare Health Science, Oita University,
Japan
- Department of Rehabilitation, Soejima Orthopedic Hospital,
Japan
| | - Yuji Kawabata
- Department of Rehabilitation Medicine, Shuto General
Hospital, JA Yamaguchi Prefectural Welfare Federation of Agricultural Cooperative,
Japan
| | - Takako Ishii
- Department of Orthopedic, Soejima Orthopedic Hospital,
Japan
| | - Masaya Anan
- Physical Therapy Course, Faculty of Welfare and Health
Science, Oita University: 700 Dannoharu, Oita-shi, Oita 870-1192, Japan
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Bailo G, Saibene FL, Bandini V, Arcuri P, Salvatore A, Meloni M, Castagna A, Navarro J, Lencioni T, Ferrarin M, Carpinella I. Characterization of Walking in Mild Parkinson's Disease: Reliability, Validity and Discriminant Ability of the Six-Minute Walk Test Instrumented with a Single Inertial Sensor. SENSORS (BASEL, SWITZERLAND) 2024; 24:662. [PMID: 38276354 PMCID: PMC10821195 DOI: 10.3390/s24020662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 01/15/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024]
Abstract
Although the 6-Minute Walk Test (6MWT) is among the recommended clinical tools to assess gait impairments in individuals with Parkinson's disease (PD), its standard clinical outcome consists only of the distance walked in 6 min. Integrating a single Inertial Measurement Unit (IMU) could provide additional quantitative and objective information about gait quality complementing standard clinical outcome. This study aims to evaluate the test-retest reliability, validity and discriminant ability of gait parameters obtained by a single IMU during the 6MWT in subjects with mild PD. Twenty-two people with mild PD and ten healthy persons performed the 6MWT wearing an IMU placed on the lower trunk. Features belonging to rhythm and pace, variability, regularity, jerkiness, intensity, dynamic instability and symmetry domains were computed. Test-retest reliability was evaluated through the Intraclass Correlation Coefficient (ICC), while concurrent validity was determined by Spearman's coefficient. Mann-Whitney U test and the Area Under the receiver operating characteristic Curve (AUC) were then applied to assess the discriminant ability of reliable and valid parameters. Results showed an overall high reliability (ICC ≥ 0.75) and multiple significant correlations with clinical scales in all domains. Several features exhibited significant alterations compared to healthy controls. Our findings suggested that the 6MWT instrumented with a single IMU can provide reliable and valid information about gait features in individuals with PD. This offers objective details about gait quality and the possibility of being integrated into clinical evaluations to better define walking rehabilitation strategies in a quick and easy way.
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Affiliation(s)
- Gaia Bailo
- IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy; (G.B.); (F.L.S.); (V.B.); (P.A.); (A.S.); (A.C.); (J.N.); (T.L.); (I.C.)
| | - Francesca Lea Saibene
- IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy; (G.B.); (F.L.S.); (V.B.); (P.A.); (A.S.); (A.C.); (J.N.); (T.L.); (I.C.)
| | - Virginia Bandini
- IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy; (G.B.); (F.L.S.); (V.B.); (P.A.); (A.S.); (A.C.); (J.N.); (T.L.); (I.C.)
| | - Pietro Arcuri
- IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy; (G.B.); (F.L.S.); (V.B.); (P.A.); (A.S.); (A.C.); (J.N.); (T.L.); (I.C.)
| | - Anna Salvatore
- IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy; (G.B.); (F.L.S.); (V.B.); (P.A.); (A.S.); (A.C.); (J.N.); (T.L.); (I.C.)
| | - Mario Meloni
- Neurology Unit, Azienda Ospedaliero-Universitaria, 09123 Cagliari, Italy;
| | - Anna Castagna
- IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy; (G.B.); (F.L.S.); (V.B.); (P.A.); (A.S.); (A.C.); (J.N.); (T.L.); (I.C.)
| | - Jorge Navarro
- IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy; (G.B.); (F.L.S.); (V.B.); (P.A.); (A.S.); (A.C.); (J.N.); (T.L.); (I.C.)
| | - Tiziana Lencioni
- IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy; (G.B.); (F.L.S.); (V.B.); (P.A.); (A.S.); (A.C.); (J.N.); (T.L.); (I.C.)
| | - Maurizio Ferrarin
- IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy; (G.B.); (F.L.S.); (V.B.); (P.A.); (A.S.); (A.C.); (J.N.); (T.L.); (I.C.)
| | - Ilaria Carpinella
- IRCCS Fondazione Don Carlo Gnocchi, 20148 Milan, Italy; (G.B.); (F.L.S.); (V.B.); (P.A.); (A.S.); (A.C.); (J.N.); (T.L.); (I.C.)
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Ting KC, Lin YC, Chan CT, Tu TY, Shih CC, Liu KC, Tsao Y. Inertial Measurement Unit-Based Romberg Test for Assessing Adults With Vestibular Hypofunction. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE 2023; 12:245-255. [PMID: 38196821 PMCID: PMC10776102 DOI: 10.1109/jtehm.2023.3334238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 08/22/2023] [Accepted: 10/18/2023] [Indexed: 01/11/2024]
Abstract
This work aims to explore the utility of wearable inertial measurement units (IMUs) for quantifying movement in Romberg tests and investigate the extent of movement in adults with vestibular hypofunction (VH). A cross-sectional study was conducted at an academic tertiary medical center between March 2021 and April 2022. Adults diagnosed with unilateral vestibular hypofunction (UVH) or bilateral vestibular hypofunction (BVH) were enrolled in the VH group. Healthy controls (HCs) were recruited from community or outpatient clinics. The IMU-based instrumented Romberg and tandem Romberg tests on the floor were applied to both groups. The primary outcomes were kinematic body metrics (maximum acceleration [ACC], mean ACC, root mean square [RMS] of ACC, and mean sway velocity [MV]) along the medio-lateral (ML), cranio-caudal (CC), and antero-posterior (AP) axes. A total of 31 VH participants (mean age, 33.48 [SD 7.68] years; 19 [61%] female) and 31 HCs (mean age, 30.65 [SD 5.89] years; 18 [58%] female) were recruited. During the eyes-closed portion of the Romberg test, VH participants demonstrated significantly higher maximum ACC and increased RMS of ACC in head movement, as well as higher maximum ACC in pelvic movement along the ML axis. In the same test condition, individuals with BVH exhibited notably higher maximum ACC and RMS of ACC along the ML axis in head and pelvic movements compared with HCs. Additionally, BVH participants exhibited markedly increased maximum ACC along the ML axis in head movement during the eyes-open portion of the tandem Romberg test. Conversely, no significant differences were found between UVH participants and HCs in the assessed parameters. The instrumented Romberg and tandem Romberg tests characterized the kinematic differences in head, pelvis, and ankle movement between VH and healthy adults. The findings suggest that these kinematic body metrics can be useful for screening BVH and can provide goals for vestibular rehabilitation.
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Affiliation(s)
- Kuan-Chung Ting
- Department of Otolaryngology-Head and Neck SurgeryTaipei Veterans General HospitalTaipei11217Taiwan
- Institute of Clinical Medicine, National Yang Ming Chiao Tung UniversityTaipei11221Taiwan
- School of MedicineNational Yang Ming Chiao Tung UniversityTaipei11221Taiwan
| | - Yu-Chieh Lin
- Department of Biomedical EngineeringNational Yang Ming Chiao Tung UniversityTaipei11221Taiwan
| | - Chia-Tai Chan
- Department of Biomedical EngineeringNational Yang Ming Chiao Tung UniversityTaipei11221Taiwan
| | - Tzong-Yang Tu
- Department of Otolaryngology-Head and Neck SurgeryTaipei Veterans General HospitalTaipei11217Taiwan
| | - Chun-Che Shih
- Institute of Clinical Medicine, National Yang Ming Chiao Tung UniversityTaipei11221Taiwan
- Division of Cardiovascular SurgeryTaipei Municipal Wanfang HospitalTaipei11608Taiwan
- Taipei Heart Institute, Taipei Medical UniversityTaipei11013Taiwan
| | - Kai-Chun Liu
- Research Center for Information Technology InnovationAcademia SinicaTaipei11529Taiwan
| | - Yu Tsao
- Research Center for Information Technology InnovationAcademia SinicaTaipei11529Taiwan
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9
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Nurse CA, Lewis CL, Shefelbine SJ. Frontal plane pelvic kinematics during high velocity running: Association with hamstring injury history. Phys Ther Sport 2023; 64:133-139. [PMID: 37890340 DOI: 10.1016/j.ptsp.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 10/29/2023]
Abstract
INTRODUCTION Hamstring injuries are the most prevalent non-contact soft tissue injury in sports, with a larger portion of injuries being recurrent. The sagittal plane running kinematics correlated to hamstring injury history has been well documented. However, analysis of frontal plane kinematics allows for observation of stability and symmetry. This study aimed to examine the frontal plane running kinematics of elite collegiate level sprinters, with and without previous hamstring injury, compared to healthy counterparts. METHODS Thirty-nine participants performed three 50-m sprints, with three inertial measurement unit sensors placed on the pelvis: one on each iliac crest and one on the sacrum. Participants were classified based on sex, competitive status, and injury history. To investigate differences based on group classification, the data were used to analyze mediolateral motion (relative magnitude of mediolateral acceleration) and asymmetry (difference in acceleration between right and left iliac crests) during each stance phase throughout the run. RESULTS Injured sprinters displayed significantly greater mediolateral motion and asymmetry during stances than healthy counterparts. CONCLUSIONS This study demonstrates that frontal plane running stance dynamics are different in athletes with previous hamstring injury than healthy athletes. These athletes may benefit from rehabilitation strategies targeting postural control and stability during dynamic tasks.
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Affiliation(s)
- Cameron A Nurse
- Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, 37215, USA.
| | - Cara L Lewis
- Department of Physical Therapy, Boston University, Boston, MA, 02215, MA, USA.
| | - Sandra J Shefelbine
- Department of Bioengineering, Northeastern University, Boston, MA, 02115, USA; Department of Mechanical Engineering & Industrial Engineering, Northeastern University, Boston, MA, 02115, USA.
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10
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Gigonzac M, Terrier P. Restoring walking ability in older adults with arm-in-arm gait training: study protocol for the AAGaTT randomized controlled trial. BMC Geriatr 2023; 23:542. [PMID: 37674129 PMCID: PMC10481504 DOI: 10.1186/s12877-023-04255-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 08/24/2023] [Indexed: 09/08/2023] Open
Abstract
CONTEXT Falls are a significant problem among older adults. While balance and functional exercises have been shown to be effective, it remains unclear whether regular walking has specific effects on reducing the risk of falls. RATIONALE Older people who fall frequently have impaired gait patterns. Recent studies have suggested using interpersonal synchronization: while walking arm-in-arm, an older person synchronizes steps with a younger person to reinstate a better gait pattern. This method of gait training may reduce the risk of falls. OBJECTIVE The aim is to assess the efficacy of an arm-in-arm gait-training program in older people. DESIGN The arm-in-arm gait training trial (AAGaTT) is a single-site, open label, two-arm, randomized controlled trial. PARTICIPANTS We will enroll 66 dyads of older people and their younger "gait instructors". The older participants must be > 70 years old with adequate walking ability. They must have experienced a fall in the year prior to study entry. INTERVENTION Dyads will walk an indoor course for 30 min either side-by-side without contact (control group) or arm-in-arm while synchronizing their gait (intervention group). The gait training will be repeated three times a week for four weeks. OUTCOMES The main outcome will be the walking speed measured in five-minute walking trials performed at baseline and at the end of each intervention week (week 1 - week 4), and at week 7. Gait quality will be assessed using accelerometers. We will also assess perceived physical activity and health using questionnaires. Finally, we will monitor fall incidence over 18 months. We will evaluate whether outcomes are more improved in the intervention group compared to the control group. In addition, interviews will be conducted to assess the perception of the gait training. EXPECTED RESULTS Recent advances in the neurophysiology of motor control have shown that synchronizing gait to external cues or to a human partner can increase the efficiency of gait training. The expected benefits of arm-in-arm gait training are: reduced risk of falls, safe treatment with no adverse effects, and high adherence. This gait training program could be a low-cost intervention with positive effects on the health and well-being of seniors. TRIAL REGISTRATION ClinicalTrials.gov NCT05627453. Date of registration: 11.25.2022.
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Affiliation(s)
- Mathilde Gigonzac
- Haute Ecole Arc Santé, HES-SO University of Applied Sciences and Arts Western Switzerland, Neuchâtel, Switzerland
| | - Philippe Terrier
- Haute Ecole Arc Santé, HES-SO University of Applied Sciences and Arts Western Switzerland, Neuchâtel, Switzerland.
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11
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Jung S, de l’Escalopier N, Oudre L, Truong C, Dorveaux E, Gorintin L, Ricard D. A Machine Learning Pipeline for Gait Analysis in a Semi Free-Living Environment. SENSORS (BASEL, SWITZERLAND) 2023; 23:4000. [PMID: 37112339 PMCID: PMC10145775 DOI: 10.3390/s23084000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/03/2023] [Accepted: 04/13/2023] [Indexed: 06/19/2023]
Abstract
This paper presents a novel approach to creating a graphical summary of a subject's activity during a protocol in a Semi Free-Living Environment. Thanks to this new visualization, human behavior, in particular locomotion, can now be condensed into an easy-to-read and user-friendly output. As time series collected while monitoring patients in Semi Free-Living Environments are often long and complex, our contribution relies on an innovative pipeline of signal processing methods and machine learning algorithms. Once learned, the graphical representation is able to sum up all activities present in the data and can quickly be applied to newly acquired time series. In a nutshell, raw data from inertial measurement units are first segmented into homogeneous regimes with an adaptive change-point detection procedure, then each segment is automatically labeled. Then, features are extracted from each regime, and lastly, a score is computed using these features. The final visual summary is constructed from the scores of the activities and their comparisons to healthy models. This graphical output is a detailed, adaptive, and structured visualization that helps better understand the salient events in a complex gait protocol.
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Affiliation(s)
- Sylvain Jung
- Université Paris Saclay, Université Paris Cité, ENS Paris Saclay, CNRS, SSA, INSERM, Centre Borelli, F-91190 Gif-sur-Yvette, France
- Université Sorbonne Paris Nord, L2TI, UR 3043, F-93430 Villetaneuse, France
- AbilyCare, 130 Rue de Lourmel, F-75015 Paris, France
- ENGIE Lab CRIGEN, F-93249 Stains, France
| | - Nicolas de l’Escalopier
- Université Paris Cité, Université Paris Saclay, ENS Paris Saclay, CNRS, SSA, INSERM, Centre Borelli, F-75006 Paris, France
- Service de Neurologie, Service de Santé des Armées, HIA Percy, F-92190 Clamart, France
| | - Laurent Oudre
- Université Paris Saclay, Université Paris Cité, ENS Paris Saclay, CNRS, SSA, INSERM, Centre Borelli, F-91190 Gif-sur-Yvette, France
| | - Charles Truong
- Université Paris Saclay, Université Paris Cité, ENS Paris Saclay, CNRS, SSA, INSERM, Centre Borelli, F-91190 Gif-sur-Yvette, France
| | - Eric Dorveaux
- AbilyCare, 130 Rue de Lourmel, F-75015 Paris, France
| | - Louis Gorintin
- Novakamp, 10-12 Avenue du Bosquet, F-95560 Baillet en France, France
| | - Damien Ricard
- Université Paris Cité, Université Paris Saclay, ENS Paris Saclay, CNRS, SSA, INSERM, Centre Borelli, F-75006 Paris, France
- Service de Neurologie, Service de Santé des Armées, HIA Percy, F-92190 Clamart, France
- Ecole du Val-de-Grâce, Service de Santé des Armées, F-75005 Paris, France
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12
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Khan Z, Jiao X, Hu T, Shao Q, Sun X, Zhao X, Gu D. Investigation of gait, balance and lower extremity muscle activity during walking in patients with cervical spondylotic myelopathy using wearable sensors. Spine J 2023:S1529-9430(23)00106-7. [PMID: 36934793 DOI: 10.1016/j.spinee.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 02/28/2023] [Accepted: 03/10/2023] [Indexed: 03/21/2023]
Abstract
BACKGROUND CONTEXT Cervical spondylotic myelopathy (CSM) is a degenerative disease caused by cervical cord compression and can lead to the significant impairment of motor function including gait and balance disturbances and changes in lower extremity muscle activity. PURPOSE This study aimed to characterize gait, balance and lower extremity muscle activity in patients with CSM compared to age-matched healthy controls (HCs) using wearable sensors in the clinical setting. STUDY DESIGN Non-Randomized, prospective cohort study. PATIENT SAMPLE 10 CSM patients and 10 age-matched HCs were recruited for this study. OUTCOME MEASURES Gait and balance function parameters contained spatial temporal parameters, step regularity (SR1), stride regularity (SR2) and harmonic ratio (HR). EMG muscle activity parameters included time to peak and peak value during loading, stance, and swing phase. METHODS In this study, parameters of gait and balance function were extracted using triaxial accelerometer attached to the spinous processes of Lumbar 5 while participants performed an overground walking at a self-preferred speed. Moreover, muscular activity was simultaneously recorded via sEMG sensors attached to tibialis anterior (TA), rectus femoris (RF), bicep femoris (BF) and gastrocnemius lateral (GL). Independent sample t-test was used to find the differences between CSM patients and HCs. RESULTS Gait analysis showed cadence, step length and walking speed were statistically significantly lower in CSM patients than HCs. Stride time was significantly higher for CSM patients in comparison to HCs. Lower root mean square ratio (RMSR) of acceleration in the mediolateral (ML) direction, HR in the anteroposterior (AP) direction, SR1 in the AP direction and SR2 in all three directions were observed in CSM patients. For muscle activity analysis, EMG RMS for TA and RF during loading phase and RMS for GL during midstance phase was significantly lower for CSM patients, while significantly higher value was observed for RF RMS during midstance phase and GL RMS during swing phase in CSM patients. CONCLUSION Our pilot study shows that wearable sensors are able to detect the changes of gait, balance and lower extremity muscle activities of CSM patients in the clinical setting. This pilot study sets the stage for future researches on the diagnosis and monitor progression of CSM disease using wearable technology.
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Affiliation(s)
- Zawar Khan
- Shanghai Key Laboratory of Orthopaedic Implants and Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai 200011, China; School of Biomedical Engineering & Med-X Research Institute, Shanghai Jiao Tong University, Shanghai 200030, China; Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai 200030, China
| | - Xin Jiao
- Shanghai Key Laboratory of Orthopaedic Implants and Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai 200011, China; School of Biomedical Engineering & Med-X Research Institute, Shanghai Jiao Tong University, Shanghai 200030, China; Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai 200030, China
| | - Tianyi Hu
- Shanghai Key Laboratory of Orthopaedic Implants and Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai 200011, China; School of Biomedical Engineering & Med-X Research Institute, Shanghai Jiao Tong University, Shanghai 200030, China; Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai 200030, China
| | - Qineng Shao
- School of Biomedical Engineering & Med-X Research Institute, Shanghai Jiao Tong University, Shanghai 200030, China; Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai 200030, China
| | - Xin Sun
- Shanghai Key Laboratory of Orthopaedic Implants and Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai 200011, China
| | - Xin Zhao
- Shanghai Key Laboratory of Orthopaedic Implants and Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai 200011, China.
| | - Dongyun Gu
- Shanghai Key Laboratory of Orthopaedic Implants and Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, Shanghai 200011, China; School of Biomedical Engineering & Med-X Research Institute, Shanghai Jiao Tong University, Shanghai 200030, China; Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education, Shanghai 200030, China.
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13
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Castiglia SF, Trabassi D, Tatarelli A, Ranavolo A, Varrecchia T, Fiori L, Di Lenola D, Cioffi E, Raju M, Coppola G, Caliandro P, Casali C, Serrao M. Identification of Gait Unbalance and Fallers Among Subjects with Cerebellar Ataxia by a Set of Trunk Acceleration-Derived Indices of Gait. CEREBELLUM (LONDON, ENGLAND) 2023; 22:46-58. [PMID: 35079958 DOI: 10.1007/s12311-021-01361-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/20/2021] [Indexed: 02/01/2023]
Abstract
This study aimed to assess the ability of 25 gait indices to characterize gait instability and recurrent fallers among persons with primary degenerative cerebellar ataxia (pwCA), regardless of gait speed, and investigate their correlation with clinical and kinematic variables. Trunk acceleration patterns were acquired during the gait of 34 pwCA, and 34 age- and speed-matched healthy subjects (HSmatched) using an inertial measurement unit. We calculated harmonic ratios (HR), percent recurrence, percent determinism, step length coefficient of variation, short-time largest Lyapunov exponent (sLLE), normalized jerk score, log-dimensionless jerk (LDLJ-A), root mean square (RMS), and root mean square ratio of accelerations (RMSR) in each spatial direction for each participant. Unpaired t-tests or Mann-Whitney tests were performed to identify significant differences between the pwCA and HSmatched groups. Receiver operating characteristics were plotted to assess the ability to characterize gait alterations in pwCA and fallers. Optimal cutoff points were identified, and post-test probabilities were calculated. The HRs showed to characterize gait instability and pwCA fallers with high probabilities. They were correlated with disease severity and stance, swing, and double support duration, regardless of gait speed. sLLEs, RMSs, RMSRs, and LDLJ-A were slightly able to characterize the gait of pwCA but failed to characterize fallers.
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Affiliation(s)
- Stefano Filippo Castiglia
- Department of Medical and Surgical Sciences and Biotechnologies, "Sapienza" University of Rome-Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy.
| | - Dante Trabassi
- Department of Medical and Surgical Sciences and Biotechnologies, "Sapienza" University of Rome-Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy
| | - Antonella Tatarelli
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, via Fontana Candida, 1, Monte Porzio Catone, 00078, Rome, Italy.,Department of Human Neurosciences, Sapienza University of Rome, viale dell'Università 30, 00185, Rome, Italy
| | - Alberto Ranavolo
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, via Fontana Candida, 1, Monte Porzio Catone, 00078, Rome, Italy
| | - Tiwana Varrecchia
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, via Fontana Candida, 1, Monte Porzio Catone, 00078, Rome, Italy
| | - Lorenzo Fiori
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, INAIL, via Fontana Candida, 1, Monte Porzio Catone, 00078, Rome, Italy.,Department of Physiology and Pharmacology, Sapienza University of Rome, piazzale Aldo Moro, 5, 00185, Rome, Italy
| | - Davide Di Lenola
- Department of Medical and Surgical Sciences and Biotechnologies, "Sapienza" University of Rome-Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy
| | - Ettore Cioffi
- Department of Medical and Surgical Sciences and Biotechnologies, "Sapienza" University of Rome-Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy.,Department of Human Neurosciences, Sapienza University of Rome, viale dell'Università 30, 00185, Rome, Italy
| | - Manikandan Raju
- Department of Human Neurosciences, Sapienza University of Rome, viale dell'Università 30, 00185, Rome, Italy
| | - Gianluca Coppola
- Department of Medical and Surgical Sciences and Biotechnologies, "Sapienza" University of Rome-Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy
| | - Pietro Caliandro
- Unità Operativa Complessa Neurologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli, 8, 00168, Rome, Italy
| | - Carlo Casali
- Department of Medical and Surgical Sciences and Biotechnologies, "Sapienza" University of Rome-Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy
| | - Mariano Serrao
- Department of Medical and Surgical Sciences and Biotechnologies, "Sapienza" University of Rome-Polo Pontino, Corso della Repubblica 79, 04100, Latina, Italy.,Movement Analysis Laboratory, Policlinico Italia, Piazza del Campidano, 6, 00162, Rome, Italy
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14
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Ahmed I, Ahmad M, Chehri A, Jeon G. A Smart-Anomaly-Detection System for Industrial Machines Based on Feature Autoencoder and Deep Learning. MICROMACHINES 2023; 14:154. [PMID: 36677215 PMCID: PMC9863665 DOI: 10.3390/mi14010154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/02/2023] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
Machine-health-surveillance systems are gaining popularity in industrial manufacturing systems due to the widespread availability of low-cost devices, sensors, and internet connectivity. In this regard, artificial intelligence provides valuable assistance in the form of deep learning methods to analyze and process big machine data. In diverse industrial applications, gears are considered a condemning element; many contributing failures occur due to an unexpected breakdown of the gears. In recent research, anomaly-detection and fault-diagnosis systems have been the gears' most contributing content. Thus, in work, we presented a smart deep learning-based system to detect anomalies in an industrial machine. Our system used vibrational analysis methods as a deciding tool for different machinery-maintenance decisions. We will first perform a data analysis of the gearbox data set to analyze the data's insights. By calculating and examining the machine's vibration, we aim to determine the nature and severity of the defect in the machine and hence detect the anomaly. A gearbox's vibration signal holds the fault's signature in the gears, and earlier fault detection of the gearbox is achievable by examining the vibration signal using a deep learning technique. Therefore, we aim to propose a 6-layer autoencoder-based deep learning framework for anomaly detection and fault analysis using a publically available data set of wind-turbine components. The gearbox fault-diagnosis data set is utilized for experimentation, including collecting vibration attributes recorded using SpectraQuest's gearbox fault-diagnostics simulator. Through comprehensive experiments, we have seen that the framework gains good results compared to others, with an overall accuracy of 91%.
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Affiliation(s)
- Imran Ahmed
- School of Computing and Information Science, Anglia Ruskin University, Cambridge CB1 1PT, UK
| | - Misbah Ahmad
- Department of Animal and Agriculture, Hartpury University, Gloucester GL19 3BE, UK
- Faculty of Health and Applied Sciences, University of West of England, Bristol BS16 1QY, UK
| | - Abdellah Chehri
- Department of Mathematics and Computer Science, Royal Military College of Canada, Station Forces, Kingston, ON K7K 7B4, Canada
| | - Gwanggil Jeon
- Department of Embedded Systems Engineering, Incheon National University, 19 Academy-ro, Yeonsu-gu, Incheon 22012, Republic of Korea
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15
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Electro-suit treatment of children with unilateral cerebral palsy alters nonlinear dynamics of walking. Clin Biomech (Bristol, Avon) 2022; 98:105714. [PMID: 35839741 DOI: 10.1016/j.clinbiomech.2022.105714] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 06/23/2022] [Accepted: 07/01/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Cerebral palsy (CP) is characterized by spasticity and muscle contracture development and associated with mild to severe motor impairments including reduced gait function. Treatment with the Exopulse® suit has been shown to reduce spasticity of the affected muscles and constitutes a non-invasive alternative to pharmaceutical agents and surgical denervation. The present study investigated the effect of systematic treatment with the Exopulse® suit on the nonlinear dynamics and variability of trunk accelerations during walking in children with unilateral CP. METHODS Twelve patients (mean age: 12 years, range 7-17 years) with unilateral CP (GMFCS level 1 and 2) received 24 weeks Exopulse® suit treatment with patient-specific muscle stimulation. Before and after the treatment, the patients completed 4 min treadmill walking while trunk accelerometry was obtained. The nonlinear dynamics was quantified by the largest Lyapunov exponent and the complexity index from the multiscale entropy and movement variability was quantified by the root mean square ratio. Pre- vs post-treatment differences were evaluated by a paired Student's t-test. FINDINGS The largest Lyapunov exponent (p-value = 0.041) and the complexity index (p-value = 0.030) of the acceleration in the anterior-posterior direction was significantly lower post-treatment. No other between-trial differences were observed. INTERPRETATION The present study suggests that 24 weeks of Exopulse® suit treatment alters the nonlinear dynamics but not the variability of the trunk accelerations during walking in children with unilateral CP. The temporal structure of the trunk acceleration in the anterior-posterior direction was altered towards that of healthy individuals.
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16
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Dimmick HL, van Rassel CR, MacInnis MJ, Ferber R. Between-Day Reliability of Commonly Used IMU Features during a Fatiguing Run and the Effect of Speed. SENSORS 2022; 22:s22114129. [PMID: 35684750 PMCID: PMC9185649 DOI: 10.3390/s22114129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 05/20/2022] [Accepted: 05/26/2022] [Indexed: 11/27/2022]
Abstract
The purpose of this study was to determine if fatigue-related changes in biomechanics derived from an inertial measurement unit (IMU) placed at the center of mass (CoM) are reliable day-to-day. Sixteen runners performed two runs at maximal lactate steady state (MLSS) on a treadmill, one run 5% above MLSS speed, and one run 5% below MLSS speed while wearing a CoM-mounted IMU. Trials were performed to volitional exhaustion or a specified termination time. IMU features were derived from each axis and the resultant. Feature means were calculated for each subject during non-fatigued and fatigued states. Comparisons were performed between the two trials at MLSS and between all four trials. The only significant fatigue state × trial interaction was the 25th percentile of the results when comparing all trials. There were no main effects for trial for either comparison method. There were main effects for fatigue state for most features in both comparison methods. Reliability, measured by an intraclass coefficient (ICC), was good-to-excellent for most features. These results suggest that fatigue-related changes in biomechanics derived from a CoM-mounted IMU are reliable day-to-day when participants ran at or around MLSS and are not significantly affected by slight deviations in speed.
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Affiliation(s)
- Hannah L. Dimmick
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (C.R.v.R.); (M.J.M.); (R.F.)
- Correspondence: ; Tel.: +1-403-220-2874
| | - Cody R. van Rassel
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (C.R.v.R.); (M.J.M.); (R.F.)
| | - Martin J. MacInnis
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (C.R.v.R.); (M.J.M.); (R.F.)
| | - Reed Ferber
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada; (C.R.v.R.); (M.J.M.); (R.F.)
- Faculty of Nursing, University of Calgary, Calgary, AB T2N 1N4, Canada
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada
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Carpinella I, Gervasoni E, Anastasi D, Di Giovanni R, Tacchino A, Brichetto G, Confalonieri P, Solaro C, Rovaris M, Ferrarin M, Cattaneo D. Walking With Horizontal Head Turns Is Impaired in Persons With Early-Stage Multiple Sclerosis Showing Normal Locomotion. Front Neurol 2022; 12:821640. [PMID: 35153994 PMCID: PMC8833075 DOI: 10.3389/fneur.2021.821640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 12/30/2021] [Indexed: 11/26/2022] Open
Abstract
Background Turning the head while walking (an action often required during daily living) is particularly challenging to maintain balance. It can therefore potentially reveal subtle impairments in early-stage people with multiple sclerosis who still show normal locomotion (NW-PwMS). This would help in identifying those subjects who can benefit from early preventive exercise aimed at slowing the MS-related functional decline. Objectives To analyze if the assessment of walking with horizontal head turns (WHHT) through inertial sensors can discriminate between healthy subjects (HS) and NW-PwMS and between NW-PwMS subgroups. To assess if the discriminant ability of the instrumented WHHT is higher compared to clinical scores. To assess the concurrent validity of the sensor-based metrics. Methods In this multicenter study, 40 HS and 59 NW-PwMS [Expanded Disability Status Scale (EDSS) ≤ 2.5, disease duration ≤ 5 years] were tested. Participants executed Item-6 of the Fullerton Advanced Balance scale-short (FAB-s) wearing three inertial sensors on the trunk and ankles. The item required to horizontally turn the head at a beat of the metronome (100 bpm) while walking. Signals of the sensors were processed to compute spatiotemporal, regularity, symmetry, dynamic stability, and trunk sway metrics descriptive of WHHT. Results Mediolateral regularity, anteroposterior symmetry, and mediolateral stability were reduced in NW-PwMS vs. HS (p ≤ 0.001), and showed moderate discriminant ability (area under the receiver operator characteristic curve [AUC]: 0.71–0.73). AP symmetry and ML stability were reduced (p ≤ 0.026) in EDSS: 2–2.5 vs. EDSS: 0–1.5 subgroup (AUC: 0.69–0.70). The number of NW-PwMS showing at least one abnormal instrumented metric (68%) was larger (p ≤ 0.002) than the number of participants showing abnormal FAB-s-Item6 (32%) and FAB-s clinical scores (39%). EDSS: 2–2.5 subgroup included more individuals showing abnormal instrumented metrics (86%) compared to EDSS: 0–1.5 subgroup (57%). The instrumented metrics significantly correlated with FAB-s-Item6 and FAB-s scores (|Spearman's rs| ≥ 0.37, p < 0.001), thus demonstrating their concurrent validity. Conclusion The instrumented assessment of WHHT provided valid objective metrics that discriminated, with higher sensitivity than clinical scores, between HS and NW-PwMS and between EDSS subgroups. The method is a promising tool to complement clinical evaluation, and reveal subclinical impairments in persons who can benefit from early preventive rehabilitative interventions.
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Affiliation(s)
| | | | | | - Rachele Di Giovanni
- Centro di Recupero e Rieducazione Funzionale (CRRF) Mons. Luigi Novarese, Moncrivello, Italy
| | - Andrea Tacchino
- Italian Multiple Sclerosis Foundation, Scientific Research Area, Genoa, Italy
| | - Giampaolo Brichetto
- Italian Multiple Sclerosis Foundation, Scientific Research Area, Genoa, Italy
| | | | - Claudio Solaro
- Centro di Recupero e Rieducazione Funzionale (CRRF) Mons. Luigi Novarese, Moncrivello, Italy
| | | | | | - Davide Cattaneo
- IRCSS Fondazione Don Carlo Gnocchi, Milan, Italy
- Department of Physiopathology and Transplants, University of Milan, Milan, Italy
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18
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Plooij M, Apte S, Keller U, Baines P, Sterke B, Asboth L, Courtine G, von Zitzewitz J, Vallery H. Neglected physical human-robot interaction may explain variable outcomes in gait neurorehabilitation research. Sci Robot 2021; 6:eabf1888. [PMID: 34550719 DOI: 10.1126/scirobotics.abf1888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- M Plooij
- Department of Biomechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, Netherlands.,Demcon Advanced Mechatronics, Delfttechpark 23, Delft, Netherlands.,Motek, a DIH brand, Hogehilweg 18-C, 1101 CD Amsterdam, Netherlands
| | - S Apte
- Department of Biomechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, Netherlands.,Laboratory of Movement Analysis and Measurement, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - U Keller
- ONWARD, EPFL Innovation Park, Lausanne, Switzerland.,Center for Neuroprosthetics (CNP) Valais, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland.,Swiss Children's Rehab, University Children's Hospital Zurich, Affoltern am Albis, Switzerland
| | - P Baines
- Department of Biomechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, Netherlands
| | - B Sterke
- Motek, a DIH brand, Hogehilweg 18-C, 1101 CD Amsterdam, Netherlands.,Department of Rehabilitation Medicine, Erasmus MC, Postbus 2040, 3000 CA Rotterdam, Netherlands
| | - L Asboth
- Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland.,Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Defitech Center for Interventional Neurotherapies (NeuroRestore), EPFL/CHUV/UNIL, Lausanne, Switzerland
| | - G Courtine
- ONWARD, EPFL Innovation Park, Lausanne, Switzerland.,Center for Neuroprosthetics and Brain Mind Institute, School of Life Sciences, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland.,Department of Clinical Neuroscience, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland.,Defitech Center for Interventional Neurotherapies (NeuroRestore), EPFL/CHUV/UNIL, Lausanne, Switzerland
| | - J von Zitzewitz
- ONWARD, EPFL Innovation Park, Lausanne, Switzerland.,Center for Neuroprosthetics (CNP) Valais, École Polytechnique Fédérale de Lausanne (EPFL), Lausanne, Switzerland
| | - H Vallery
- Department of Biomechanical Engineering, Delft University of Technology, Mekelweg 2, 2628 CD Delft, Netherlands.,Department of Rehabilitation Medicine, Erasmus MC, Postbus 2040, 3000 CA Rotterdam, Netherlands
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19
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Nohelova D, Bizovska L, Vuillerme N, Svoboda Z. Gait Variability and Complexity during Single and Dual-Task Walking on Different Surfaces in Outdoor Environment. SENSORS (BASEL, SWITZERLAND) 2021; 21:4792. [PMID: 34300532 PMCID: PMC8309897 DOI: 10.3390/s21144792] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/09/2021] [Accepted: 07/11/2021] [Indexed: 11/28/2022]
Abstract
Nowadays, gait assessment in the real life environment is gaining more attention. Therefore, it is desirable to know how some factors, such as surfaces (natural, artificial) or dual-tasking, influence real life gait pattern. The aim of this study was to assess gait variability and gait complexity during single and dual-task walking on different surfaces in an outdoor environment. Twenty-nine healthy young adults aged 23.31 ± 2.26 years (18 females, 11 males) walked at their preferred walking speed on three different surfaces (asphalt, cobbles, grass) in single-task and in two dual-task conditions (manual task-carrying a cup filled with water, cognitive task-subtracting the number 7). A triaxial inertial sensor attached to the lower trunk was used to record trunk acceleration during gait. From 15 strides, sample entropy (SampEn) as an indicator of gait complexity and root mean square (RMS) as an indicator of gait variability were computed. The findings demonstrate that in an outdoor environment, the surfaces significantly impacted only gait variability, not complexity, and that the tasks affected both gait variability and complexity in young healthy adults.
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Affiliation(s)
- Denisa Nohelova
- Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacký University Olomouc, 771 11 Olomouc, Czech Republic; (L.B.); (Z.S.)
- Laboratory AGEIS, Université Grenoble Alpes, AGEIS, 38000 Grenoble, France;
- LabCom Telecom4Health, Orange Labs & Université Grenoble Alpes, CNRS, Inria, Grenoble INP-UGA, 38000 Grenoble, France
| | - Lucia Bizovska
- Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacký University Olomouc, 771 11 Olomouc, Czech Republic; (L.B.); (Z.S.)
| | - Nicolas Vuillerme
- Laboratory AGEIS, Université Grenoble Alpes, AGEIS, 38000 Grenoble, France;
- LabCom Telecom4Health, Orange Labs & Université Grenoble Alpes, CNRS, Inria, Grenoble INP-UGA, 38000 Grenoble, France
- Institut Universitaire de France, 75231 Paris, France
| | - Zdenek Svoboda
- Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacký University Olomouc, 771 11 Olomouc, Czech Republic; (L.B.); (Z.S.)
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20
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Oliveira LM, Roizenblatt S, Silva FD, Roizenblatt A, Fernandes ARC, Szejnfeld VL. Relationship of the sacral slope with early gait derangements in robust older women. Adv Rheumatol 2021; 61:35. [PMID: 34118988 DOI: 10.1186/s42358-021-00191-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 05/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Trunk pelvic dissociation is fundamental to the compensatory mechanism for muscle weakness during body bending. We carried out an early investigation of gait changes in a sample of community-dwelling women ≥60 years without gait complaints. The primary objective was to correlate spine and pelvic angles with performance tests and accelerometry parameters. The secondary objective was to correlate performance tests with accelerometry. METHODS In this cross-sectional study, 54 community-dwelling women ≥60 years were subjected to Falls Efficacy Scale-International (FES-I), performance tests (Berg Balance Scale, Timed Up and Go, and Gait analysis), and radiographic analysis of sagittal alignment (Thoracic and Lumbar Cobb, Pelvic Incidence, Sacral Slope, and Pelvic Tilt angles). Gait speed was assessed in a 10-m comfortable walk, and accelerometry parameters were obtained in a 30-m walk distance. RESULTS The sample, aged 72 ± 6 years, exhibited moderate correlation between Sacral Slope and Step Length (+ 0.615). Sacral Slope weakly correlated with FES-I (- 0.339), Berg Balance Scale (+ 0.367), and with further accelerometry data in the AP plane: RMS, (+ 0.439) and Stride Regularity (+ 0.475), p < 0.05, all. Lumbar Cobb weakly correlated with the following accelerometry data in the AP plane: Step Length (+ 0.405), RMS, (+ 0.392), and Stride Regularity (+ 0.345), p < 0.05, all. Additionally, Stride Regularity in AP moderately correlated with FES-I (0,561, p < 0.05), among other weak correlations between performance tests and accelerometry data in AP. CONCLUSIONS Early alterations in Sacral Slope and gait abnormalities in the AP plane may provide understanding of the early gait changes in robust older women.
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Affiliation(s)
| | - Suely Roizenblatt
- Department of Internal Medicine, Universidade Federal de Sao Paulo (UNIFESP), Rua Angelina Maffei Vita 670. CEP:01455070, Sao Paulo, SP, Brazil.
| | - Flavio Duarte Silva
- Department of Diagnostic Imaging, Universidade Federal de Sao Paulo (UNIFESP), São Paulo, Brazil
| | - Arnaldo Roizenblatt
- Medical Student Universidade Federal de Sao Paulo (UNIFESP), São Paulo, Brazil
| | | | - Vera Lucia Szejnfeld
- Rheumatology Division, Universidade Federal de Sao Paulo (UNIFESP), São Paulo, Brazil
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21
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Luo Y, Lu X, Ahrentzen S, Hu B. Impact of destination-based visual cues on gait characteristics among adults over 75 years old: A pilot study. Gait Posture 2021; 87:110-116. [PMID: 33906089 DOI: 10.1016/j.gaitpost.2021.04.030] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 04/13/2021] [Accepted: 04/16/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Visual information is a contributing factor affecting human gait and balance, especially in low lit environments. To mitigate the adverse effects of poor lighting conditions and help older adults perceive their positions in a community-dwelling setting, destination-based visual perceptual cues were designed as a specific lighting intervention and the effectiveness of the lighting intervention was tested in this study. RESEARCH QUESTIONS 1) Does the designed lighting intervention improve older adults' walking performance? 2) Does the designed lighting intervention change older adults' walking strategy? METHODS Fifteen community-dwelling older adults (165.5 ± 9.3 cm, 6 males, 9 females) were recruited. Participants were instructed to walk from their bed to the bathroom repeatedly in two lighting conditions, their usual nightlight condition and a novel LED strip lighting condition. Human motion patterns, including walking performance, lower-limb kinematics, and trunk motions, were recorded and analyzed. To investigate the effect of visual cues on walking behaviors, one-way analysis of variance (ANOVA) were performed with lighting conditions as the within-subject factor. RESULTS Destination-based visual perceptual cues induced less walking time among adults over 75 years old, compared to the usual nightlight condition. The decrease in walking time was accompanied by changes in other walking behaviors, including decreased hip flexion, increased ankle flexion, larger trunk planar acceleration RMS, and smoother trunk log dimensionless jerk. SIGNIFICANCE This study demonstrated the effectiveness of the designed lighting intervention upon the changes in older adults' walking performance and strategies. With the help of destination-based visual perceptual cues, the older adults spent a shorter period of time walking to their destination (i.e., walking faster), with an improvement in their walking strategies, such as mitigated lower-body biomechanical plasticity and smoother trunk movement.
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Affiliation(s)
- Yue Luo
- Department of Industrial and Systems Engineering, University of Florida, Gainesville, FL, USA
| | - Xiaojie Lu
- Shimberg Center for Housing Studies, University of Florida, Gainesville, FL, USA
| | - Sherry Ahrentzen
- Shimberg Center for Housing Studies, University of Florida, Gainesville, FL, USA
| | - Boyi Hu
- Department of Industrial and Systems Engineering, University of Florida, Gainesville, FL, USA.
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22
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Mesquita EDM, Rodrigues FB, Rodrigues AP, Lemes TS, Andrade AO, Vieira MF. Discrimination capability of linear and nonlinear gait features in group classification. Med Eng Phys 2021; 93:59-71. [PMID: 34154776 DOI: 10.1016/j.medengphy.2021.05.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 02/26/2021] [Accepted: 05/25/2021] [Indexed: 11/17/2022]
Abstract
The variability of human movement can be defined as normal variations occurring in motor activity and quantified using linear statistics or nonlinear methods. In the human movement field, linear and nonlinear measures of variability have been used to discriminate groups and conditions in different contexts. Indeed, some authors support the idea that these gait features provide complementary information about movement. However, it is unclear which type of gait variability measure best discriminates different groups or conditions, as a comparison of the discrimination capacity between linear and nonlinear gait variability features in different groups has not been assessed. Therefore, the main objective of this study was to test the discrimination capacity of linear and nonlinear gait features to determine which type of feature would be the most efficient for discriminating older and younger adults and between lower limb amputees and nonamputees using classification algorithms. Data from previously published studies were used. The classification task was performed using the k-nearest neighbors and random forest algorithms. Our results showed that using a combination of linear and nonlinear features resulted in the highest mean accuracy rates (>90%) in group classification, reinforcing the idea that these features are complementary and express different aspects of movement.
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Affiliation(s)
- Eduardo de Mendonça Mesquita
- Bioengineering and Biomechanics Laboratory, Federal University of Goiás, Avenida Esperança s/n, Campus Samambaia, 74690-900 Goiânia, Goiás, Brazil.
| | - Fábio Barbosa Rodrigues
- Bioengineering and Biomechanics Laboratory, Federal University of Goiás, Avenida Esperança s/n, Campus Samambaia, 74690-900 Goiânia, Goiás, Brazil; State University of Goiás - UnU Trindade, Trindade, Brazil
| | - Adriano Péricles Rodrigues
- Bioengineering and Biomechanics Laboratory, Federal University of Goiás, Avenida Esperança s/n, Campus Samambaia, 74690-900 Goiânia, Goiás, Brazil
| | - Thiago Santana Lemes
- Bioengineering and Biomechanics Laboratory, Federal University of Goiás, Avenida Esperança s/n, Campus Samambaia, 74690-900 Goiânia, Goiás, Brazil
| | - Adriano O Andrade
- Center for Innovation and Technology Assessment in Health, Federal University of Uberlândia, Uberlândia, Brazil
| | - Marcus Fraga Vieira
- Bioengineering and Biomechanics Laboratory, Federal University of Goiás, Avenida Esperança s/n, Campus Samambaia, 74690-900 Goiânia, Goiás, Brazil
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23
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Zhang Y, Wang H, Yao Y, Liu J, Sun X, Gu D. Walking stability in patients with benign paroxysmal positional vertigo: an objective assessment using wearable accelerometers and machine learning. J Neuroeng Rehabil 2021; 18:56. [PMID: 33789693 PMCID: PMC8011133 DOI: 10.1186/s12984-021-00854-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 03/17/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Benign paroxysmal positional vertigo (BPPV) is one of the most common peripheral vestibular disorders leading to balance difficulties and increased fall risks. This study aims to investigate the walking stability of BPPV patients in clinical settings and propose a machine-learning-based classification method for determining the severity of gait disturbances of BPPV. METHODS Twenty-seven BPPV outpatients and twenty-seven healthy subjects completed level walking trials at self-preferred speed in clinical settings while wearing two accelerometers on the head and lower trunk, respectively. Temporo-spatial variables and six walking stability related variables [root mean square (RMS), harmonic ratio (HR), gait variability, step/stride regularity, and gait symmetry] derived from the acceleration signals were analyzed. A support vector machine model (SVM) based on the gait variables of BPPV patients were developed to differentiate patients from healthy controls and classify the handicapping effects of dizziness imposed by BPPV. RESULTS The results showed that BPPV patients employed a conservative gait and significantly reduced walking stability compared to the healthy controls. Significant different mediolateral HR at the lower trunk and anteroposterior step regularity at the head were found in BPPV patients among mild, moderate, and severe DHI (dizziness handicap inventory) subgroups. SVM classification achieved promising accuracies with area under the curve (AUC) of 0.78, 0.83, 0.85 and 0.96 respectively for differentiating patients from healthy controls and classifying the three stages of DHI subgroups. Study results suggest that the proposed gait analysis that is based on the coupling of wearable accelerometers and machine learning provides an objective approach for assessing gait disturbances and handicapping effects of dizziness imposed by BPPV.
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Affiliation(s)
- Yuqian Zhang
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, People's Republic of China.,School of Biomedical Engineering and Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, 200030, People's Republic of China.,Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education of People's Republic China, Shanghai, 200030, People's Republic of China
| | - He Wang
- School of Biomedical Engineering and Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, 200030, People's Republic of China.,Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education of People's Republic China, Shanghai, 200030, People's Republic of China
| | - Yifei Yao
- School of Biomedical Engineering and Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, 200030, People's Republic of China.,Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education of People's Republic China, Shanghai, 200030, People's Republic of China
| | - Jianren Liu
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, People's Republic of China
| | - Xuhong Sun
- Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, People's Republic of China.
| | - Dongyun Gu
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, People's Republic of China. .,School of Biomedical Engineering and Med-X Research Institute, Shanghai Jiao Tong University, Shanghai, 200030, People's Republic of China. .,Engineering Research Center of Digital Medicine and Clinical Translation, Ministry of Education of People's Republic China, Shanghai, 200030, People's Republic of China.
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24
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Soangra R, Lockhart T. Smartphone-Based Prediction Model for Postoperative Cardiac Surgery Outcomes Using Preoperative Gait and Posture Measures. SENSORS 2021; 21:s21051704. [PMID: 33801240 PMCID: PMC7958120 DOI: 10.3390/s21051704] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/16/2021] [Accepted: 02/23/2021] [Indexed: 11/16/2022]
Abstract
Gait speed assessment increases the predictive value of mortality and morbidity following older adults' cardiac surgery. The purpose of this study was to improve clinical assessment and prediction of mortality and morbidity among older patients undergoing cardiac surgery through the identification of the relationships between preoperative gait and postural stability characteristics utilizing a noninvasive-wearable mobile phone device and postoperative cardiac surgical outcomes. This research was a prospective study of ambulatory patients aged over 70 years undergoing non-emergent cardiac surgery. Sixteen older adults with cardiovascular disease (Age 76.1 ± 3.6 years) scheduled for cardiac surgery within the next 24 h were recruited for this study. As per the Society of Thoracic Surgeons (STS) recommendation guidelines, eight of the cardiovascular disease (CVD) patients were classified as frail (prone to adverse outcomes with gait speed ≤0.833 m/s) and the remaining eight patients as non-frail (gait speed >0.833 m/s). Treating physicians and patients were blinded to gait and posture assessment results not to influence the decision to proceed with surgery or postoperative management. Follow-ups regarding patient outcomes were continued until patients were discharged or transferred from the hospital, at which time data regarding outcomes were extracted from the records. In the preoperative setting, patients performed the 5-m walk and stand still for 30 s in the clinic while wearing a mobile phone with a customized app "Lockhart Monitor" available at iOS App Store. Systematic evaluations of different gait and posture measures identified a subset of smartphone measures most sensitive to differences in two groups (frail versus non-frail) with adverse postoperative outcomes (morbidity/mortality). A regression model based on these smartphone measures tested positive on five CVD patients. Thus, clinical settings can readily utilize mobile technology, and the proposed regression model can predict adverse postoperative outcomes such as morbidity or mortality events.
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Affiliation(s)
- Rahul Soangra
- Crean College of Health and Behavioral Sciences, Chapman University, Orange, CA 92866, USA;
- Fowler School of Engineering, Chapman University, Orange, CA 92866, USA
| | - Thurmon Lockhart
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ 85287, USA
- Correspondence: ; Tel.: +1-540-257-3058
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25
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Dasgupta P, VanSwearingen J, Godfrey A, Redfern M, Montero-Odasso M, Sejdic E. Acceleration Gait Measures as Proxies for Motor Skill of Walking: A Narrative Review. IEEE Trans Neural Syst Rehabil Eng 2021; 29:249-261. [PMID: 33315570 PMCID: PMC7995554 DOI: 10.1109/tnsre.2020.3044260] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
In adults 65 years or older, falls or other neuromotor dysfunctions are often framed as walking-related declines in motor skill; the frequent occurrence of such decline in walking-related motor skill motivates the need for an improved understanding of the motor skill of walking. Simple gait measurements, such as speed, do not provide adequate information about the quality of the body motion's translation during walking. Gait measures from accelerometers can enrich measurements of walking and motor performance. This review article will categorize the aspects of the motor skill of walking and review how trunk-acceleration gait measures during walking can be mapped to motor skill aspects, satisfying a clinical need to understand how well accelerometer measures assess gait. We will clarify how to leverage more complicated acceleration measures to make accurate motor skill decline predictions, thus furthering fall research in older adults.
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26
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Angelini L, Buckley E, Bonci T, Radford A, Sharrack B, Paling D, Nair KPS, Mazza C. A Multifactorial Model of Multiple Sclerosis Gait and Its Changes Across Different Disability Levels. IEEE Trans Biomed Eng 2021; 68:3196-3204. [PMID: 33625975 DOI: 10.1109/tbme.2021.3061998] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Mobility assessment is critical in the clinical management of people with Multiple Sclerosis (pwMS). Instrumented gait analysis provides a plethora of metrics for quantifying concurrent factors contributing to gait deterioration. However, a gait model discriminating underlying features contributing to this deterioration is lacking in pwMS. This study aimed at developing and validating such a model. METHODS The gait of 24 healthy controls and 114 pwMS with mild, moderate, or severe disability was measured with inertial sensors on the shanks and lower trunk while walking for 6 minutes along a hospital corridor. Twenty out of thirty-six initially explored metrics computed from the sensor data met the quality criteria for exploratory factor analysis. This analysis provided the sought model, which underwent a confirmatory factor analysis before being used to characterize gait impairment across the three disability groups. RESULTS A gait model consisting of five domains (rhythm/variability, pace, asymmetry, and forward and lateral dynamic balance) was revealed by the factor analysis, which was able to highlight gait abnormalities across the disability groups: significant alterations in rhythm/variability-, asymmetry-, and pace-based features were present in the mild group, but these were more profound in the moderate and severe groups. Deterioration in dynamic balance-based features was only noted in pwMS with a moderate and severe disability. CONCLUSION A conceptual model of gait for disease-specific mobility assessment in pwMS was successfully developed and tested. SIGNIFICANCE The new model, built with metrics that represent gait impairment in pwMS, highlighted clinically relevant changes across different disability levels, including those with no clinically observable walking disability. This shows the clear potential as a monitoring biomarker in pwMS.
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27
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Crowley P, Vuillerme N, Samani A, Madeleine P. The effects of walking speed and mobile phone use on the walking dynamics of young adults. Sci Rep 2021; 11:1237. [PMID: 33441673 PMCID: PMC7806980 DOI: 10.1038/s41598-020-79584-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 12/10/2020] [Indexed: 11/09/2022] Open
Abstract
Walking while using a mobile phone has been shown to affect the walking dynamics of young adults. However, this has only been investigated using treadmill walking at a fixed walking speed. In this study, the dynamics of over ground walking were investigated using lower trunk acceleration measured over 12 consecutive trials, following differing walking speed and mobile phone use instructions. Higher walking speed significantly increased the proportion of acceleration along the vertical measurement axis, while decreasing the proportion of acceleration along the anteroposterior axis (p < 0.001). Moreover, higher walking speed also resulted in increased sample entropy along all measurement axes (p < 0.05). When walking while texting, the maximum Lyapunov exponent increased along the anteroposterior and vertical measurement axes (p < 0.05), while sample entropy decreased significantly along the vertical axis (p < 0.001). Walking speed and mobile phone use both affect the walking dynamics of young adults. Walking while texting appears to produce a reduction in local dynamic stability and an increase in regularity, however, caution is required when interpreting the extent of this task effect, since walking speed also affected walking dynamics.
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Affiliation(s)
- Patrick Crowley
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark. .,University of Grenoble Alpes, AGEIS, Grenoble, France. .,The National Research Centre for the Working Environment, Lersø Parkallé 105, Copenhagen, Denmark.
| | - Nicolas Vuillerme
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.,University of Grenoble Alpes, AGEIS, Grenoble, France.,Institut Universitaire de France, Paris, France.,LabCom Telecom4Health, University of Grenoble Alpes and Orange Labs, Grenoble, France
| | - Afshin Samani
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | - Pascal Madeleine
- Sport Sciences - Performance and Technology, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
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28
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Saida T, Kawada M, Kuroki D, Nakai Y, Miyazaki T, Kiyama R, Tsuneyoshi Y. Accelerometer Measurement of Trunk Lateral Fluctuation During Walking Following Total Knee Arthroplasty in Patients With Osteoarthritis. J Aging Phys Act 2020; 28:669-674. [PMID: 32208361 DOI: 10.1123/japa.2019-0149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Revised: 12/10/2019] [Accepted: 12/14/2019] [Indexed: 11/18/2022]
Abstract
This study aimed to clarify the effect of total knee arthroplasty (TKA) on trunk fluctuation and regularity of gait in patients with knee osteoarthritis by an accelerometer. The participants included 18 patients with knee osteoarthritis undergoing TKA. The gait at a comfortable velocity was assessed pre- and post-TKA by a triaxial accelerometer attached to the neck and lumbar regions. Measurement post-TKA was performed 4 weeks after surgery. Trunk fluctuation was estimated by the root mean square (RMS) of acceleration and RMS ratio (the ratio of RMS in each direction to the total RMS). Regularity of gait was estimated using the autocorrelation function. The results showed that TKA significantly decreased the RMS ratio in mediolateral acceleration of the neck and lumbar regions and reduced gait regularity. TKA appears to reduce compensatory trunk motion through the improvement of knee function. An assessment of trunk fluctuation using an accelerometer is useful for the clinical assessment of patients with knee osteoarthritis pre- and post-TKA.
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29
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Storm FA, Cesareo A, Reni G, Biffi E. Wearable Inertial Sensors to Assess Gait during the 6-Minute Walk Test: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2020; 20:E2660. [PMID: 32384806 PMCID: PMC7249076 DOI: 10.3390/s20092660] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 04/23/2020] [Accepted: 05/05/2020] [Indexed: 12/12/2022]
Abstract
Wearable sensors are becoming increasingly popular for complementing classical clinical assessments of gait deficits. The aim of this review is to examine the existing knowledge by systematically reviewing a large number of papers focusing on the use of wearable inertial sensors for the assessment of gait during the 6-minute walk test (6MWT), a widely recognized, simple, non-invasive, low-cost and reproducible exercise test. After a systematic search on PubMed and Scopus databases, two raters evaluated the quality of 28 full-text articles. Then, the available knowledge was summarized regarding study design, subjects enrolled (number of patients and pathological condition, if any, age, male/female ratio), sensor characteristics (type, number, sampling frequency, range) and body placement, 6MWT protocol and extracted parameters. Results were critically discussed to suggest future directions for the use of inertial sensor devices in the clinics.
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Affiliation(s)
- Fabio Alexander Storm
- Scientific Institute, IRCCS “E. Medea”, Bioengineering Lab, 23842 Bosisio Parini, Lecco, Italy; (A.C.); (G.R.); (E.B.)
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Winter SC, Gordon S, Brice SM, Lindsay D, Barrs S. A Multifactorial Approach to Overuse Running Injuries: A 1-Year Prospective Study. Sports Health 2020; 12:296-303. [PMID: 31994970 DOI: 10.1177/1941738119888504] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Because of the complex and multifaceted nature of running injuries, a multifactorial approach when investigating running injuries is required. HYPOTHESIS Compared with uninjured runners, injured runners would exhibit different running biomechanics, display more fatigue changes, and would run a greater weekly running volume; more injured runners would also report having a previous injury. STUDY DESIGN Prospective cohort study. LEVEL OF EVIDENCE Level 4. METHODS At commencement of the study, data were collected on demographics, anthropometrics, training history, previous injury history, and center-of-mass accelerations during a long-distance overground run. Participants completed weekly training diaries and were monitored for 1 year for an injury. RESULTS A total of 76 runners completed the study, with 39 (22 male; 17 female) reporting an injury. Compared with male uninjured runners, male injured runners were heavier and ran a greater weekly distance. Male runners (injured and uninjured) exhibited increases in mediolateral center-of-mass accelerations during the run. Compared with female uninjured runners, female injured runners were heavier, ran with longer flight times and lower step frequencies, and more of them had reported an injury in the previous year and had increased speed training in the weeks prior to injury. Over 60% of male injured runners and over 50% of female injured runners had increased their weekly running distance by >30% between consecutive weeks at least once in the 4 weeks prior to injury. CONCLUSION Factors that may be related to injury for male runners include being heavier, running a greater weekly distance, and exhibiting fatigue changes in mediolateral center-of-mass accelerations. Factors that may be related to injury for female runners include being heavier, having an injury in the previous year, running with longer flight times and lower step frequencies, and increasing speed training prior to injury. Increases in weekly running distance in 1 consecutive week (particularly >30%) needs to be monitored in training, and this along with the other factors found may have contributed to injury development. CLINICAL RELEVANCE This study found that multiple factors are related to running injuries and that some factors are sex specific. The findings can aid in injury prevention and management.
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Affiliation(s)
- Sara C Winter
- College of Healthcare Sciences, James Cook University, Townsville, Queensland, Australia
| | - Susan Gordon
- College of Healthcare Sciences, James Cook University, Townsville, Queensland, Australia.,School of Health Sciences, Flinders University, Bedford Park, South Australia, Australia
| | - Sara M Brice
- College of Science and Engineering, James Cook University, Townsville, Queensland, Australia
| | - Daniel Lindsay
- College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Sue Barrs
- College of Healthcare Sciences, James Cook University, Townsville, Queensland, Australia
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Caramia C, Bibbo D, D'Anna C, Marchis CD, Ranaldi S, Varrecchia T, Conforto S, Schmid M. Wearable-based Temporal Parameters of Gait in Circuitous Routes under Dual-Task Conditions. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2019:1224-1227. [PMID: 31946113 DOI: 10.1109/embc.2019.8856531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
12 young adults were requested to walk along a circuitous path including turns, slaloms, stair ascending and descending, while wearing an inertial sensor placed on the back at the lumbar level. The path was completed under two conditions: with no additive cognitive task, and while performing a cognitive task and texting on a smartphone. Different temporal global parameters of gait were extracted from the inertial sensor data, to check for differences driven by the presence of the cognitive task. Regularity, durations, and temporal characteristics of gait resulted significantly affected from the presence of the additional task, and this effect was only in part due to a modification coming from the decrease in walking speed.
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Tamura T. Progress of Home Healthcare Sensor in Our Experience: Development of Wearable and Unobtrusive Monitoring. ADVANCED BIOMEDICAL ENGINEERING 2020. [DOI: 10.14326/abe.9.189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Toshiyo Tamura
- Intitute of Healthcare Robotics, Future Robotics Organization, Waseda University
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Bumann H, Nüesch C, Loske S, Byrnes SK, Kovacs B, Janssen R, Schären S, Mündermann A, Netzer C. Severity of degenerative lumbar spinal stenosis affects pelvic rigidity during walking. Spine J 2020; 20:112-120. [PMID: 31479778 DOI: 10.1016/j.spinee.2019.08.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 08/20/2019] [Accepted: 08/23/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT To understand the role of compensation mechanisms in the development and treatment of symptomatic degenerative lumbar spinal stenosis (DLSS), pelvic stability during walking should be objectively assessed in the context of clinical parameters. PURPOSE To determine the association among duration of symptoms, lumbar muscle atrophy, disease severity, pelvic stability during walking, and surgical outcome in patients with DLSS scheduled for decompression surgery. STUDY DESIGN/SETTING Prospective observational study with intervention. PATIENT SAMPLE Patients with symptomatic DLSS. OUTCOME MEASURES Oswestry Disability Index score; duration of symptoms; lumbar muscle atrophy; severity grade; pelvis rigidity during walking. METHODS Patients with symptomatic DLSS were analyzed on the day before surgery and 10 weeks and 12 months postoperatively. Duration of symptoms was categorized as: <2years, <5years, and >5years. Muscle atrophy at the stenosis level was categorized according to Goutallier. Bilateral cross-sectional areas of the erector spinae and psoas muscles were quantified from magnetic resonance imaging. Stenosis grade was assessed using the Schizas classification. Pelvic tilt was measured in standing radiographs. Pelvic rigidity during walking was assessed as root mean square of the pelvic acceleration in each direction (anteroposterior, mediolateral, and vertical) normalized to walking speed measured using an inertial sensor attached to the skin between the posterior superior iliac spine. RESULTS Body mass index but not duration of symptoms, lumbar muscle atrophy, pelvic rigidity, and stenosis grade explained changes in Oswestry Disability Index from before to after surgery. Patients with greater stenosis grade had greater pelvic rigidity during walking. Lumbar muscle atrophy did not correlate with pelvic rigidity during walking. Patients with lower stenosis grade had greater muscle atrophy and patients with smaller erector spinae and psoas muscle cross-sectional areas had a greater pelvis tilt. CONCLUSIONS Greater pelvic rigidity during walking may represent a compensatory mechanism of adopting a protective body position to keep the spinal canal more open during walking and hence reduce pain. Pelvic rigidity during walking may be a useful screening parameter for identifying early compensating mechanisms. Whether it can be used as a parameter for personalized treatment planning or outcome prognosis necessitates further evaluation.
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Affiliation(s)
- Helen Bumann
- Department of Spine Surgery, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland
| | - Corina Nüesch
- Department of Spine Surgery, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland; Department of Orthopedics and Traumatology, University Hospital Basel, Basel, Switzerland; Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Stefan Loske
- Department of Orthopedics and Traumatology, University Hospital Basel, Basel, Switzerland
| | - S Kimberly Byrnes
- Department of Orthopedics and Traumatology, University Hospital Basel, Basel, Switzerland; Faculty for Sport and Health Science, Technische Universität München, Munich, Germany
| | - Balázs Kovacs
- Department of Radiology, University Hospital Basel, Basel, Switzerland
| | - Ruben Janssen
- Department of Radiology, University Hospital Basel, Basel, Switzerland
| | - Stefan Schären
- Department of Spine Surgery, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland
| | - Annegret Mündermann
- Department of Spine Surgery, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland; Department of Orthopedics and Traumatology, University Hospital Basel, Basel, Switzerland; Department of Biomedical Engineering, University of Basel, Basel, Switzerland; Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Cordula Netzer
- Department of Spine Surgery, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland.
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Is a Wearable Sensor-Based Characterisation of Gait Robust Enough to Overcome Differences Between Measurement Protocols? A Multi-Centric Pragmatic Study in Patients with Multiple Sclerosis. SENSORS 2019; 20:s20010079. [PMID: 31877760 PMCID: PMC6983011 DOI: 10.3390/s20010079] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/17/2019] [Accepted: 12/18/2019] [Indexed: 12/16/2022]
Abstract
Inertial measurement units (IMUs) allow accurate quantification of gait impairment of people with multiple sclerosis (pwMS). Nonetheless, it is not clear how IMU-based metrics might be influenced by pragmatic aspects associated with clinical translation of this approach, such as data collection settings and gait protocols. In this study, we hypothesised that these aspects do not significantly alter those characteristics of gait that are more related to quality and energetic efficiency and are quantifiable via acceleration related metrics, such as intensity, smoothness, stability, symmetry, and regularity. To test this hypothesis, we compared 33 IMU-based metrics extracted from data, retrospectively collected by two independent centres on two matched cohorts of pwMS. As a worst-case scenario, a walking test was performed in the two centres at a different speed along corridors of different lengths, using different IMU systems, which were also positioned differently. The results showed that the majority of the temporal metrics (9 out of 12) exhibited significant between-centre differences. Conversely, the between-centre differences in the gait quality metrics were small and comparable to those associated with a test-retest analysis under equivalent conditions. Therefore, the gait quality metrics are promising candidates for reliable multi-centric studies aiming at assessing rehabilitation interventions within a routine clinical context.
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Winter SC, Gordon S, Brice SM, Lindsay D, Barrs S. Overuse injuries in runners of different abilities-a one-year prospective study. Res Sports Med 2019; 29:196-212. [PMID: 31146574 DOI: 10.1080/15438627.2019.1616548] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The aim of this prospective study was to investigate differences in participant characteristics, previous injury, running dynamics during a long-distance run, and training between injured and uninjured runners in runners of different abilities. Center-of-mass acceleration data were collected during a long-distance overground run. Runners were then divided into four groups (elite, advanced, intermediate and slow) based on their finishing time. Participants completed training diaries and were monitored for 1 year. Seventy-six runners completed the prospective study with 39 (51.3%) sustaining a running injury (44% elite, 42% advanced, 54% intermediate, 59% slow). Differences between injured and uninjured runners within each group related to injury included: (1) elite injured runners ran with longer contact times and (2) more slow injured runners reported an injury in previous year, were heavier, had higher body mass and body mass index, ran with lower step frequencies, and ran a greater weekly distance. Advanced injured runners exhibited fatigue changes in step regularity and peak braking during the run that may be related to injury. These findings suggest that runners of different abilities may have different factors related to injury however due to the small sample sizes in the groups this needs to be explored further.
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Affiliation(s)
- Sara C Winter
- College of Healthcare Sciences, James Cook University , Townsville, Australia
| | - Susan Gordon
- College of Healthcare Sciences, James Cook University , Townsville, Australia.,School of Health Sciences, Flinders University , Bedford Park, Australia
| | - Sara M Brice
- College of Science and Engineering, James Cook University , Townsville, Australia
| | - Daniel Lindsay
- College of Public Health, Medical and Veterinary Sciences, James Cook University , Townsville, Australia
| | - Sue Barrs
- College of Healthcare Sciences, James Cook University , Townsville, Australia
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Misu S, Asai T, Doi T, Sawa R, Ueda Y, Murata S, Saito T, Sugimoto T, Isa T, Tsuboi Y, Yamada M, Ono R. Development and validation of Comprehensive Gait Assessment using InerTial Sensor score (C-GAITS score) derived from acceleration and angular velocity data at heel and lower trunk among community-dwelling older adults. J Neuroeng Rehabil 2019; 16:62. [PMID: 31138310 PMCID: PMC6540531 DOI: 10.1186/s12984-019-0539-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 05/17/2019] [Indexed: 11/10/2022] Open
Abstract
Background Although some gait parameters from inertial sensors have been shown to be associated with important clinical issues, because of controversial results, it remains uncertain which parameters for which axes are clinically valuable. Following the idea that a comprehensive score obtained by summing various gait parameters would sensitively reflect declines in gait performance, we developed a scoring method for community-dwelling older adults, the Comprehensive Gait Assessment using InerTial Sensor score (C-GAITS score). The aim of this study was to examine the internal consistency and the construct validity of this method. Methods In this cross-sectional study, the gait performance of 378 community-dwelling older people (mean age = 71.7 ± 4.2 years, 210 women) was assessed using inertial sensors attached to the heel and lower trunk. Participants walked along a 15-m walkway, and accelerations, angular velocity, and walking time were measured. From these data, walking speed, mean stride time, coefficients of variation of stride time and swing time, and autocorrelation coefficients and harmonic ratios of acceleration in vertical, mediolateral, and anteroposterior directions at the lower trunk were calculated. Scoring was performed based on quartile by gender (i.e., scored from 0 to 3) for each of the 10 gait parameters. The C-GAITS score was the sum of these scores (range: 0–30). Lower extremity strength, balance function, fall history, and fear of falling were also assessed. Results An exploratory factor analysis revealed that the C-GAITS score yielded four distinct factors explaining 57.1% of the variance. The Cronbach’s alpha coefficient was 0.77. A single linear regression analysis showed a significant relationship between total C-GAITS score and walking speed (adjusted R2 = 0.28). Results from bivariate comparisons using unpaired t-tests showed that the score was significantly related to age (p = 0.002), lower extremity strength (p = 0.007), balance function (p < 0.001), fall history (p = 0.04), and fear of falling (p < 0.001). Conclusions Good internal consistency and appropriate construct validity of the C-GAITS score were confirmed among community-dwelling older adults. The score might be useful in clinical settings because of ease of use and interpretation and capability of capturing functional decline.
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Affiliation(s)
- Shogo Misu
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, 6-2-13, Morikita-machi, Higashinada-ku, Kobe, 658-0001, Japan. .,Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142, Japan.
| | - Tsuyoshi Asai
- Department of Physical Therapy, Faculty of Rehabilitation, Kobegakuin University, 516 Arise, Ikawadani-cho, Nishi-ku, Kobe, 651-2180, Japan
| | - Takehiko Doi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 35 Gengo Morioka, Obu, 474-8511, Japan
| | - Ryuichi Sawa
- Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142, Japan.,Japan Center for International Exchange, Meisan Tameike Bldg. 7F, 1-1-12 Akasaka, Minato-ku, Tokyo, 107-0052, Japan
| | - Yuya Ueda
- Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142, Japan
| | - Shunsuke Murata
- Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142, Japan.,Japan Society for the Promotion of Science, Research Fellowship for Young Scientists, Kojimachi Business Center Building, 5-3-1 Kojimachi, Chiyoda-ku, Tokyo, 102-0083, Japan
| | - Takashi Saito
- Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142, Japan
| | - Taiki Sugimoto
- Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142, Japan.,Japan Society for the Promotion of Science, Research Fellowship for Young Scientists, Kojimachi Business Center Building, 5-3-1 Kojimachi, Chiyoda-ku, Tokyo, 102-0083, Japan.,The Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan.,Medical Genome Center, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Tsunenori Isa
- Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142, Japan
| | - Yamato Tsuboi
- Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142, Japan.,Japan Center for International Exchange, Meisan Tameike Bldg. 7F, 1-1-12 Akasaka, Minato-ku, Tokyo, 107-0052, Japan
| | - Minoru Yamada
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan, 3-29-1 Otsuka, Bunkyo-ku, Tokyo, 112-0012, Japan
| | - Rei Ono
- Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, 7-10-2 Tomogaoka, Suma-ku, Kobe, 654-0142, Japan
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Kunimune S, Okada S. Contribution of vision and its age-related changes to postural stability in obstacle crossing during locomotion. Gait Posture 2019; 70:284-288. [PMID: 30925352 DOI: 10.1016/j.gaitpost.2019.03.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 03/11/2019] [Accepted: 03/12/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Obstacle crossing requires sufficient toe clearance for trip and fall prevention for which postural stability is a prerequisite. It is thought that the upper visual field plays an important role in the maintenance of postural stability, but its influence and age-dependence have not been investigated yet. RESEARCH QUESTION What is the role of the visual fields in maintaining postural stability during crossing an obstacle in young and older adults?. METHODS This study included 14 young adults and 14 older adults. The participants, wearing an accelerometer and liquid crystal shutter goggles, were asked to cross an obstacle under the following three conditions (i) full vision; (ii) total visual field occlusion at two steps before the obstacle, and (iii) lower visual field occlusion at two steps before the obstacle. The root mean square ratio in the mediolateral direction (RMSRML) for the three sections (i.e., approach to the obstacle, lead limb crossing, and trail limb crossing), as well as the root mean square in the mediolateral direction (RMSML) for each section were calculated. RESULTS RMSML during lead limb crossing was significantly increased in older adults compared to young adults (p < 0.01). There was no significant main effect of visual condition and age group on RMSRML for the three steps. SIGNIFICANCE The study results suggest postural lateral instability in older adults with poor balance ability during lead limb crossing. Regardless of age, the peripheral visual information appears to contribute minimally to the maintenance of postural lateral stability at least from two steps before the obstacle, when the participants perceived the surrounding environment and the size of the obstacle while approaching it.
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Affiliation(s)
- Sho Kunimune
- Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada-ku, Kobe-shi, Hyogo, 657-8501, Japan; Department of Rehabilitation, Midorigaoka Hospital, 3-13-1, Makamicho, Takatsuki-shi, Osaka, 569-1121, Japan.
| | - Shuichi Okada
- Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada-ku, Kobe-shi, Hyogo, 657-8501, Japan
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Hsu CY, Tsai YS, Yau CS, Shie HH, Wu CM. Differences in gait and trunk movement between patients after ankle fracture and healthy subjects. Biomed Eng Online 2019; 18:26. [PMID: 30890177 PMCID: PMC6425625 DOI: 10.1186/s12938-019-0644-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 03/11/2019] [Indexed: 12/15/2022] Open
Abstract
Background Studies have shown that gait asymmetry and activity limitation can persist several months or years after ankle fracture. However, evidence of gait and trunk movement patterns following ankle fracture during the early rehabilitation period is scarce. Thus, we compared gait patterns and trunk movement during the early phase of rehabilitation between patients with ankle fracture and matched controls. Methods Ten patients with ankle fractures, and ten age- and sex-matched healthy controls were prospectively enrolled. An automated infrared-assisted, trunk accelerometer-based gait analysis system was used to measure walking speed, step length, and cadence. The median time of the evaluation following ankle fracture was 4.0 months. Trunk movement intensity was evaluated as acceleration root mean square. Trunk movement symmetry and regularity were analysed using the autocorrelation method. Differences in gait characteristics between the patient and control groups were analysed using the Mann–Whitney U test. Follow-up assessment of falls was performed 24 months after the fracture. The correlations between Lower Extremity Functional Scale (LEFS) scores/falls and gait parameters were evaluated using Spearman’s rank correlation coefficient. Results Walking speed (p = 0.019), step length (p = 0.023), cadence (p = 0.003), and trunk movement intensity in anterior–posterior and vertical axis (p = 0.001, p = 0.003, respectively) were all significantly lower in the ankle fracture group than in the control group. Trunk movement symmetry in vertical direction (p = 0.019) decreased significantly in patients with ankle fractures, whereas between-strides regularity did not differ between groups. LEFS scores were moderately correlated with walking speed (r = 0.60, p = 0.044) and step length (r = 0.68, p = 0.021). During the 24 months after the fracture, 3 falls were reported by 3 patients. Trunk acceleration root mean square ratio in mediolateral axis (r = 0.72, p = 0.018) was highly correlated with future falls. Conclusion During early rehabilitation, patients with ankle fracture may develop trunk movement asymmetry in the vertical direction accompanied with slower walking speed and cadence, and smaller step lengths, which can contribute to muscular imbalances and potential injury. Thus, proper rehabilitation strategies should be employed for these patients.
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Affiliation(s)
- Chia-Yu Hsu
- Department of Rehabilitation Medicine, Ten-Chan General Hospital, No. 155 Yanping Rd, Zhongli Dist., Taoyuan City, 320, Taiwan.,Department of Biomedical Engineering, Chung Yuan Christian University, No. 200, Zhongbei Rd, Zhongli Dist., Taoyuan City, 320, Taiwan (ROC)
| | - Yuh-Show Tsai
- Department of Biomedical Engineering, Chung Yuan Christian University, No. 200, Zhongbei Rd, Zhongli Dist., Taoyuan City, 320, Taiwan (ROC).
| | - Cheng-Shiang Yau
- Department of Biomedical Engineering, Chung Yuan Christian University, No. 200, Zhongbei Rd, Zhongli Dist., Taoyuan City, 320, Taiwan (ROC)
| | - Hung-Hai Shie
- Department of Physiotherapy, Ten-Chan General Hospital, No. 155 Yanping Rd, Zhongli Dist., Taoyuan City, 320, Taiwan
| | - Chu-Ming Wu
- Department of Rehabilitation Medicine, Ten-Chan General Hospital, No. 155 Yanping Rd, Zhongli Dist., Taoyuan City, 320, Taiwan
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Haruyama K, Kasai K, Makino R, Hoshi F, Nishihara K. Quantification of trunk segmental coordination and head stability in laterally unstable sitting identifies aging and cerebellar ataxia. Clin Biomech (Bristol, Avon) 2019; 63:127-133. [PMID: 30889431 DOI: 10.1016/j.clinbiomech.2019.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 11/05/2018] [Accepted: 01/17/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND We quantified trunk segmental coordination and head stability in unstable sitting and investigated whether it can discriminate postural control, age-related differences and presence of coordination disorder. METHODS Subjects were a healthy younger group (n = 7), a healthy elderly group (n = 7), and a cerebellar ataxia group (n = 8). The motion sensors and surface electrodes were located on the trunk and/or head segments to measure angle displacements, acceleration and electromyograms in unstable sitting during a lateral tilt task. Trunk lateral angle cross-correlation and electromyogram cross-correlation for the trunk segmental coordination, head root mean square (RMS) for the head stability, clinical performance scales, and gait parameters (velocity, coefficient of variation, and RMS ratio) were analyzed. FINDINGS Trunk lateral angle cross-correlation showed a significantly negative correlation in the healthy younger group compared with the two other groups (p < 0.01). Head RMS showed a significantly larger value in the cerebellar ataxia group compared with the two other groups (p < 0.01). Trunk lateral angle cross-correlation had moderate correlation with the clinical performance scale of ataxia and gait parameters; however, it was not correlated with head RMS. Classification using trunk lateral angle cross-correlation and head RMS was validated by discriminant analysis and hierarchical cluster analysis. INTERPRETATION We found that trunk lateral angle cross-correlation reflected age-related differences and head RMS characterized the pathology of cerebellar ataxia. Trunk segmental coordination and head stability, as two aspects of sitting postural control, can be used to discriminate the degree of aging and cerebellar ataxia.
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Affiliation(s)
- Koshiro Haruyama
- Department of Rehabilitation Medicine, Higashisaitama National Hospital, Saitama, Japan; Department of Physical Therapy, Saitama Prefectural University, Saitama, Japan.
| | - Kenji Kasai
- Department of Physical Therapy, Saitama Prefectural Rehabilitation Center, Saitama, Japan; Department of Physical Therapy, Saitama Prefectural University, Saitama, Japan
| | - Ryohei Makino
- Department of Physical Therapy, Saitama Prefectural Rehabilitation Center, Saitama, Japan; Department of Physical Therapy, Saitama Prefectural University, Saitama, Japan
| | - Fumihiko Hoshi
- Department of Physical Therapy, Saitama Prefectural University, Saitama, Japan
| | - Ken Nishihara
- Department of Physical Therapy, Saitama Prefectural University, Saitama, Japan
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Terui Y, Iwakura M, Suto E, Kawagoshi A, Sugawara K, Takahashi H, Hasegawa K, Uemura S, Satake M, Shioya T. New evaluation of trunk movement and balance during walking in COPD patients by a triaxial accelerometer. Int J Chron Obstruct Pulmon Dis 2018; 13:3957-3962. [PMID: 30584295 PMCID: PMC6290864 DOI: 10.2147/copd.s184212] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Background Individuals with COPD may experience ambulatory difficulty due to both effort intolerance arising from respiratory dysfunction and impaired balance control during walking. However, the trunk movement during walking has not been evaluated or adjusted for patients with COPD. The Lissajous index (LI) visually and numerically evaluates the left–right symmetry of the trunk movement during walking and is useful in clinical practice. In COPD patients, the LI is used as an indicator of the left–right symmetry of the trunk during walking. Here, we used the LI to evaluate the symmetry of COPD patients based on bilateral differences in mediolateral and vertical accelerations, and we investigated the correlation between the patients’ symmetry evaluation results and their physical function. Patients and methods Sixteen stable COPD patients (all males; age 71.3±9.2 years) and 26 healthy control subjects (15 males; age 68.2±6.9 years) participated in this study. They performed the 10-minute walk test at a comfortable gait speed wearing a triaxial accelerometer, and we measured their trunk acceleration for the evaluation of symmetry. Motor functions were also evaluated in the patients with COPD. Results The average mediolateral bilateral difference and LI values of the COPD patients were significantly larger than those of the healthy subjects. The COPD patients’ LI values were significantly correlated with their static balance. Conclusion The LI measured using a triaxial accelerometer during walking is useful in balance assessments of patients with COPD.
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Affiliation(s)
- Yoshino Terui
- Department of Physical Therapy, Akita University Graduate School of Health Sciences, Akita, Japan,
| | - Masahiro Iwakura
- Department of Physical Therapy, Akita University Graduate School of Health Sciences, Akita, Japan, .,Department of Rehabilitation Medicine, Akita City Hospital, Akita, Japan
| | - Eriko Suto
- Department of Rehabilitation, Akita Prefectural Center for Rehabilitation and Psychiatric Medicine, Daisen, Japan
| | | | - Keiyu Sugawara
- Department of Rehabilitation Medicine, Akita City Hospital, Akita, Japan
| | - Hitomi Takahashi
- Department of Rehabilitation Medicine, Akita City Hospital, Akita, Japan
| | - Kouichi Hasegawa
- Department of Rehabilitation, Akita Prefectural Center for Rehabilitation and Psychiatric Medicine, Daisen, Japan
| | - Sachiko Uemura
- Department of Physical Therapy, Akita University Graduate School of Health Sciences, Akita, Japan,
| | - Masahiro Satake
- Department of Physical Therapy, Akita University Graduate School of Health Sciences, Akita, Japan,
| | - Takanobu Shioya
- Department of Physical Therapy, Akita University Graduate School of Health Sciences, Akita, Japan, .,Geriatric Health Services Facility Nikonikoen, Akita, Japan
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41
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Nguyen N, Phan D, Pathirana PN, Horne M, Power L, Szmulewicz D. Quantification of Axial Abnormality Due to Cerebellar Ataxia with Inertial Measurements. SENSORS (BASEL, SWITZERLAND) 2018; 18:E2791. [PMID: 30149564 PMCID: PMC6164665 DOI: 10.3390/s18092791] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 08/13/2018] [Accepted: 08/17/2018] [Indexed: 01/01/2023]
Abstract
Cerebellar Ataxia (CA) leads to deficiencies in muscle movement and lack of coordination that is often manifested as gait and balance disabilities. Conventional CA clinical assessments are subjective, cumbersome and provide less insight into the functional capabilities of patients. This cross-sectional study investigates the use of wearable inertial sensors strategically positioned on the front-chest and upper-back locations during the Romberg and Trunk tests for objective assessment of human postural balance due to CA. The primary aim of this paper is to quantify the performance of postural stability of 34 patients diagnosed with CA and 22 healthy subjects as controls. Several forms of entropy descriptions were considered to uncover characteristics of movements intrinsic to CA. Indeed, correlation with clinical observation is vital in ascertaining the validity of the inertial measurements in addition to capturing unique features of movements not typically observed by the practicing clinician. Both of these aspects form an integral part of the underlying objective assessment scheme. Uncertainty in the velocity contained a significant level of information with respect to truncal instability and, based on an extensive clustering and discrimination analysis, fuzzy entropy was identified as an effective measure in characterising the underlying disability. Front-chest measurements demonstrated a strong correlation with clinical assessments while the upper-back measurements performed better in classifying the two cohorts, inferring that the standard clinical assessments are relatively influenced by the frontal observations. The Romberg test was confirmed to be an effective test of neurological diagnosis as well as a potential candidate for objective assessment resulting in a significant correlation with the clinical assessments. In contrast, the Trunk test is observed to be relatively less informative.
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Affiliation(s)
- Nhan Nguyen
- Networked Sensing and Control Lab, School of Engineering, Deakin University, Waurn Ponds, VIC 3216, Australia.
| | - Dung Phan
- Networked Sensing and Control Lab, School of Engineering, Deakin University, Waurn Ponds, VIC 3216, Australia.
| | - Pubudu N Pathirana
- Networked Sensing and Control Lab, School of Engineering, Deakin University, Waurn Ponds, VIC 3216, Australia.
| | - Malcolm Horne
- Florey Institute of Neuroscience and Mental Health, Parkville, VIC 3052, Australia.
| | - Laura Power
- Balance Disorders and Ataxia Service, Royal Victorian Eye and Ear Hospital, St Andrews Place, East Melbourne, VIC 3002, Australia.
| | - David Szmulewicz
- Florey Institute of Neuroscience and Mental Health, Parkville, VIC 3052, Australia.
- Balance Disorders and Ataxia Service, Royal Victorian Eye and Ear Hospital, St Andrews Place, East Melbourne, VIC 3002, Australia.
- Cerebellar Ataxia Clinic, Caufield Hospital, Alfred Health, Caufield, VIC 3162, Australia.
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42
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Lim YH, Kim JS, Lee HW, Kim SH. Postural Instability Induced by Visual Motion Stimuli in Patients With Vestibular Migraine. Front Neurol 2018; 9:433. [PMID: 29930534 PMCID: PMC5999734 DOI: 10.3389/fneur.2018.00433] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Accepted: 05/23/2018] [Indexed: 11/13/2022] Open
Abstract
Patients with vestibular migraine are susceptible to motion sickness. This study aimed to determine whether the severity of posture instability is related to the susceptibility to motion sickness. We used a visual motion paradigm with two conditions of the stimulated retinal field and the head posture to quantify postural stability while maintaining a static stance in 18 patients with vestibular migraine and in 13 age-matched healthy subjects. Three parameters of postural stability showed differences between VM patients and controls: RMS velocity (0.34 ± 0.02 cm/s vs. 0.28 ± 0.02 cm/s), RMS acceleration (8.94 ± 0.74 cm/s2 vs. 6.69 ± 0.87 cm/s2), and sway area (1.77 ± 0.22 cm2 vs. 1.04 ± 0.25 cm2). Patients with vestibular migraine showed marked postural instability of the head and neck when visual stimuli were presented in the retinal periphery. The pseudo-Coriolis effect induced by head roll tilt was not responsible for the main differences in postural instability between patients and controls. Patients with vestibular migraine showed a higher visual dependency and low stability of the postural control system when maintaining quiet standing, which may be related to susceptibility to motion sickness.
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Affiliation(s)
- Yong-Hyun Lim
- Department of Neurology, Kyungpook National University School of Medicine, Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - Ji-Soo Kim
- Department of Neurology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seoul, South Korea
| | - Ho-Won Lee
- Department of Neurology, Kyungpook National University School of Medicine, Kyungpook National University Chilgok Hospital, Daegu, South Korea
| | - Sung-Hee Kim
- Department of Neurology, Kyungpook National University School of Medicine, Kyungpook National University Chilgok Hospital, Daegu, South Korea
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43
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Inertial Sensor-Based Variables Are Indicators of Frailty and Adverse Post-Operative Outcomes in Cardiovascular Disease Patients. SENSORS 2018; 18:s18061792. [PMID: 29865245 PMCID: PMC6021795 DOI: 10.3390/s18061792] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 05/31/2018] [Accepted: 05/31/2018] [Indexed: 11/16/2022]
Abstract
Cardiovascular disease (CVD) patients with intrinsic cardiac cause for falling have been found to be frail and submissive to morbidity and mortality as post-operative outcomes. In these older CVD patients, gait speed is conjectured by the Society of Thoracic Surgeons (STS) as an independent predictor of post-operative morbidity and mortality. However, this guideline by STS has not been studied adequately with a large sample size; rather it is based largely on expert opinions of cardiac surgeons and researchers. Although one's gait speed is not completely associated with one's risk of falls, gait speed is a quick robust measure to classify frail/non-frail CVD patients and undoubtedly frail individuals are more prone to falls. Thus, this study examines the effects of inertial sensor-based quick movement variability characteristics in identifying CVD patients likely to have an adverse post-operative outcome. This study establishes a relationship with gait and postural predictor variables with patient's post-operative adverse outcomes. Accordingly, inertial sensors embedded inside smartphones are indispensable for the assessment of elderly patients in clinical environments and may be necessary for quick objective assessment. Sixteen elderly CVD patients (Age 76.1 ± 3.6 years) who were scheduled for cardiac surgery the next day were recruited for this study. Based on STS recommendation guidelines, eight of the CVD patients were classified as frail (prone to adverse outcomes with gait speed ≤ 0.833 m/s) and the other eight patients as non-frail (gait speed > 0.833 m/s). Smartphone-derived walking velocity was found to be significantly lower in frail patients than that in non-frail patients (p < 0.01). Mean Center of Pressure (COP) radius (p < 0.01), COP Area (p < 0.01), COP path length (p < 0.05) and mean COP velocity (p < 0.05) were found to be significantly higher in frail patients than that in the non-frail patient group. Nonlinear variability measures such as sample entropy were significantly lower in frail participants in anterior-posterior (p < 0.01) and resultant sway direction (p < 0.01) than in the non-frail group. This study identified numerous postural and movement variability parameters that offer insights into predictive inertial sensor-based variables and post-operative adverse outcomes among CVD patients. In future, smartphone-based clinical measurement systems could serve as a clinical decision support system for assessing patients quickly in the perioperative period.
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Pizzamiglio S, Abdalla H, Naeem U, Turner DL. Neural predictors of gait stability when walking freely in the real-world. J Neuroeng Rehabil 2018; 15:11. [PMID: 29486775 PMCID: PMC5830090 DOI: 10.1186/s12984-018-0357-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 02/16/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Gait impairments during real-world locomotion are common in neurological diseases. However, very little is currently known about the neural correlates of walking in the real world and on which regions of the brain are involved in regulating gait stability and performance. As a first step to understanding how neural control of gait may be impaired in neurological conditions such as Parkinson's disease, we investigated how regional brain activation might predict walking performance in the urban environment and whilst engaging with secondary tasks in healthy subjects. METHODS We recorded gait characteristics including trunk acceleration and brain activation in 14 healthy young subjects whilst they walked around the university campus freely (single task), while conversing with the experimenter and while texting with their smartphone. Neural spectral power density (PSD) was evaluated in three brain regions of interest, namely the pre-frontal cortex (PFC) and bilateral posterior parietal cortex (right/left PPC). We hypothesized that specific regional neural activation would predict trunk acceleration data obtained during the different walking conditions. RESULTS Vertical trunk acceleration was predicted by gait velocity and left PPC theta (4-7 Hz) band PSD in single-task walking (R-squared = 0.725, p = 0.001) and by gait velocity and left PPC alpha (8-12 Hz) band PSD in walking while conversing (R-squared = 0.727, p = 0.001). Medio-lateral trunk acceleration was predicted by left PPC beta (15-25 Hz) band PSD when walking while texting (R-squared = 0.434, p = 0.010). CONCLUSIONS We suggest that the left PPC may be involved in the processes of sensorimotor integration and gait control during walking in real-world conditions. Frequency-specific coding was operative in different dual tasks and may be developed as biomarkers of gait deficits in neurological conditions during performance of these types of, now commonly undertaken, dual tasks.
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Affiliation(s)
- Sara Pizzamiglio
- Neuroplasticity and Neurorehabilitation Doctoral Training Programme, Neurorehabilitation Unit, School of Health, Sport and Bioscience, College of Applied Health, University of East London, E15 4LZ, London, UK. .,School of Architecture, Computing and Engineering, University of East London, University Way, London, UK.
| | - Hassan Abdalla
- School of Architecture, Computing and Engineering, University of East London, University Way, London, UK
| | - Usman Naeem
- School of Architecture, Computing and Engineering, University of East London, University Way, London, UK
| | - Duncan L Turner
- Neuroplasticity and Neurorehabilitation Doctoral Training Programme, Neurorehabilitation Unit, School of Health, Sport and Bioscience, College of Applied Health, University of East London, E15 4LZ, London, UK.,UCLP Centre for Neurorehabilitation, London, UK
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45
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Abstract
The purpose of this study was to clarify whether a gait analysis using an accelerometer could estimate gait independence. Eighty-six stroke patients and 21 healthy control subjects participated in this study. Stroke patients were identified as dependent or independent based on their gait ability. The acceleration of the trunk and bilateral thigh was measured using three wireless sensors during walking. The root mean square, gait regularity, and symmetry were calculated from the acceleration to estimate gait quality. ANCOVA showed that gait regularity of the trunk and bilateral thigh were significantly lowest in the dependent group, regardless of gait velocity. A logistic regression analysis showed that the regularity and root mean square of the anteroposterior acceleration of the unaffected thigh were the key factors for estimating gait independence. This study suggests that an acceleration-based gait analysis facilities gait independence estimation, and is a useful tool during the rehabilitation of stroke patients.
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46
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Speedtsberg MB, Christensen SB, Stenum J, Kallemose T, Bencke J, Curtis DJ, Jensen BR. Local dynamic stability during treadmill walking can detect children with developmental coordination disorder. Gait Posture 2018; 59:99-103. [PMID: 29028627 DOI: 10.1016/j.gaitpost.2017.09.035] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 08/10/2017] [Accepted: 09/27/2017] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Developmental coordination disorder (DCD) is an innate impairment of motor coordination that affects basic locomotion and balance. This study investigated local dynamic stability of trunk accelerations during treadmill walking as an objective evaluation of gait stability and the sensitivity and specificity of this measure to discriminate children with DCD from typically developing children. METHOD Eight children with DCD and ten age- and gender-matched typically developing children (TD) walked four minutes on a treadmill. Trunk accelerations in vertical, medio-lateral and anterior-posterior directions were recorded with a sternum mounted accelerometer at 256Hz. Short term local dynamic stability (λs), root mean square (RMS) and relative root mean square (RMSR) were calculated from measures of orthogonal trunk accelerations. Receiver operating characteristic curve (ROC) analysis was performed to discriminate between groups based on short term local dynamic stability. RESULTS λs was significantly greater in children with DCD in the main movement direction (AP) (DCD: 1.69±0.17 λs; TD:1.41±0.17 λs; p=0.005), indicating reduced local dynamic stability. RMS and RMSR accelerations showed no difference between children with DCD and TD children in any direction. The ROC analysis of λs in separate directions and in two dimensions showed an excellent accuracy of discriminating between children with DCD and TD children. Anterior-posterior direction in combination with medio-lateral or vertical showed best performance with an area under the curve (AUC) of 0.91. CONCLUSION We have shown that children with developmental coordination disorder have general reduced local dynamic stability and that the short term Lyapunov exponent has good power of discrimination between DCD and TD.
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Affiliation(s)
- Merete B Speedtsberg
- Laboratory of Human Movement Analysis, Department of Orthopaedic Surgery, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark; Biomechanics and Motor Control Lab., Integrated Physiology, Department of Nutrition, Exercise and Sport, University of Copenhagen, Copenhagen, Denmark.
| | - Sofie B Christensen
- Biomechanics and Motor Control Lab., Integrated Physiology, Department of Nutrition, Exercise and Sport, University of Copenhagen, Copenhagen, Denmark
| | - Jan Stenum
- Biomechanics and Motor Control Lab., Integrated Physiology, Department of Nutrition, Exercise and Sport, University of Copenhagen, Copenhagen, Denmark; Locomotion Neuromechanics Laboratory, Department of Kinesiology, University of Massachusetts Amherst, Amherst, MA, USA
| | - Thomas Kallemose
- Clinical Orthopaedic Research Hvidovre, Department of Orthopaedic Surgery, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark
| | - Jesper Bencke
- Laboratory of Human Movement Analysis, Department of Orthopaedic Surgery, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark
| | - Derek J Curtis
- Laboratory of Human Movement Analysis, Department of Orthopaedic Surgery, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark; Department of Physical and Occupational Therapy, Metropolitan University College, Copenhagen, Denmark
| | - Bente R Jensen
- Biomechanics and Motor Control Lab., Integrated Physiology, Department of Nutrition, Exercise and Sport, University of Copenhagen, Copenhagen, Denmark; Department of Neurology, Odense University Hospital, University of Southern Denmark, Odense, Denmark
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47
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Wada O, Asai T, Hiyama Y, Nitta S, Mizuno K. Root mean square of lower trunk acceleration during walking in patients with unilateral total hip replacement. Gait Posture 2017; 58:19-22. [PMID: 28704684 DOI: 10.1016/j.gaitpost.2017.07.032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 07/03/2017] [Accepted: 07/07/2017] [Indexed: 02/02/2023]
Abstract
Although several studies have described abnormal trunk motion before and after total hip arthroplasty (THA) surgery, few studies have examined trunk motion using accelerometry. The aim of this study was to determine whether abnormal trunk motion persisted after THA using accelerometry. A total of 24 female patients (61.0±6.9years) and 20 healthy female subjects (59.9±6.8years) participated in this study. Patients were assessed at 1 month prior to surgery and 12 months after surgery. Trunk acceleration during gait was measured using a triaxial accelerometer attached to the L3 spinous process. We calculated the root mean square (RMS) and RMS ratio (RMSR) in the vertical (VT), medio-lateral (ML), and anterior-posterior (AP) directions. Results revealed that the RMS in the VT and AP directions postoperatively was greater than that preoperatively, whereas there was no difference in the RMS in the ML direction. In addition, the preoperative RMSR in the ML direction was significantly greater compared with that of healthy individuals and the postoperative RMSR. There was no difference in the RMSR in the ML direction between healthy individuals and postoperatively. These findings suggested that the trunk motion in the frontal plane prior to surgery had improved and was comparable to that of healthy individuals following THA.
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Affiliation(s)
- Osamu Wada
- Anshin Hospital, 1-4-12, Minatojima Minamimachi, Chuo-ku, Kobe City, Hyogo, Japan.
| | - Tsuyoshi Asai
- Department of Physical Therapy, Faculty of Rehabilitation, Kobe Gakuin University, 518 Ikawadanicho, Arise, Nishi-ku, Kobe, Hyogo 651-2180, Japan
| | - Yoshinori Hiyama
- Department of Physical Therapy, School of Health Sciences, Tokyo University of Technology, 5-23-22, Nishikamata, Ota-ku, Tokyo, Japan
| | - Shingo Nitta
- Anshin Hospital, 1-4-12, Minatojima Minamimachi, Chuo-ku, Kobe City, Hyogo, Japan
| | - Kiyonori Mizuno
- Anshin Hospital, 1-4-12, Minatojima Minamimachi, Chuo-ku, Kobe City, Hyogo, Japan
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48
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Pizzamiglio S, Naeem U, Abdalla H, Turner DL. Neural Correlates of Single- and Dual-Task Walking in the Real World. Front Hum Neurosci 2017; 11:460. [PMID: 28959199 PMCID: PMC5603763 DOI: 10.3389/fnhum.2017.00460] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 09/01/2017] [Indexed: 01/28/2023] Open
Abstract
Recent developments in mobile brain-body imaging (MoBI) technologies have enabled studies of human locomotion where subjects are able to move freely in more ecologically valid scenarios. In this study, MoBI was employed to describe the behavioral and neurophysiological aspects of three different commonly occurring walking conditions in healthy adults. The experimental conditions were self-paced walking, walking while conversing with a friend and lastly walking while texting with a smartphone. We hypothesized that gait performance would decrease with increased cognitive demands and that condition-specific neural activation would involve condition-specific brain areas. Gait kinematics and high density electroencephalography (EEG) were recorded whilst walking around a university campus. Conditions with dual tasks were accompanied by decreased gait performance. Walking while conversing was associated with an increase of theta (θ) and beta (β) neural power in electrodes located over left-frontal and right parietal regions, whereas walking while texting was associated with a decrease of β neural power in a cluster of electrodes over the frontal-premotor and sensorimotor cortices when compared to walking whilst conversing. In conclusion, the behavioral “signatures” of common real-life activities performed outside the laboratory environment were accompanied by differing frequency-specific neural “biomarkers”. The current findings encourage the study of the neural biomarkers of disrupted gait control in neurologically impaired patients.
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Affiliation(s)
- Sara Pizzamiglio
- Neuroplasticity and Neurorehabilitation Doctoral Training Programme, Neurorehabilitation Unit, School of Health, Sport and Biosscience, University of East LondonLondon, United Kingdom.,School of Architecture, Computing and Engineering, University of East LondonLondon, United Kingdom
| | - Usman Naeem
- School of Architecture, Computing and Engineering, University of East LondonLondon, United Kingdom
| | - Hassan Abdalla
- School of Architecture, Computing and Engineering, University of East LondonLondon, United Kingdom
| | - Duncan L Turner
- Neuroplasticity and Neurorehabilitation Doctoral Training Programme, Neurorehabilitation Unit, School of Health, Sport and Biosscience, University of East LondonLondon, United Kingdom.,UCLPartners Centre for Neurorehabilitation, University College LondonLondon, United Kingdom
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49
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Schütte KH, Sackey S, Venter R, Vanwanseele B. Energy cost of running instability evaluated with wearable trunk accelerometry. J Appl Physiol (1985) 2017; 124:462-472. [PMID: 28751372 DOI: 10.1152/japplphysiol.00429.2017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Maintaining stability under dynamic conditions is an inherent challenge to bipedal running. This challenge may impose an energetic cost (Ec) thus hampering endurance running performance, yet the underlying mechanisms are not clear. Wireless triaxial trunk accelerometry is a simple tool that could be used to unobtrusively evaluate these mechanisms. Here, we test a cost of instability hypothesis by examining the contribution of trunk accelerometry-based measures (triaxial root mean square, step and stride regularity, and sample entropy) to interindividual variance in Ec (J/m) during treadmill running. Accelerometry and indirect calorimetry data were collected concurrently from 30 recreational runners (16 men; 14 women) running at their highest steady-state running speed (80.65 ± 5.99% V̇o2max). After reducing dimensionality with factor analysis, the effect of dynamic stability features on Ec was evaluated using hierarchical multiple regression analysis. Three accelerometry-based measures could explain an additional 10.4% of interindividual variance in Ec after controlling for body mass, attributed to anteroposterior stride regularity (5.2%), anteroposterior root mean square ratio (3.2%), and mediolateral sample entropy (2.0%). Our results lend support to a cost of instability hypothesis, with trunk acceleration waveform signals that are 1) more consistent between strides anteroposterioly, 2) larger in amplitude variability anteroposterioly, and 3) more complex mediolaterally and are energetically advantageous to endurance running performance. This study shows that wearable trunk accelerometry is a useful tool for understanding the Ec of running and that running stability is important for economy in recreational runners. NEW & NOTEWORTHY This study evaluates and more directly lends support to a cost of instability hypothesis between runners. Moreover, this hypothesis was tested using a minimalist setup including a single triaxial trunk mounted accelerometer, with potential transferability to biomechanical and performance analyses in typical outdoor settings.
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Affiliation(s)
- Kurt H Schütte
- Human Movement Biomechanics Research Group, Department of Kinesiology, KU Leuven, Leuven , Belgium.,Movement Laboratory, Department of Sport Science, Stellenbosch University, Stellenbosch, Western Cape, South Africa
| | - Saint Sackey
- Movement Laboratory, Department of Sport Science, Stellenbosch University, Stellenbosch, Western Cape, South Africa
| | - Rachel Venter
- Movement Laboratory, Department of Sport Science, Stellenbosch University, Stellenbosch, Western Cape, South Africa
| | - Benedicte Vanwanseele
- Human Movement Biomechanics Research Group, Department of Kinesiology, KU Leuven, Leuven , Belgium
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50
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Trunk biomechanics during hemiplegic gait after stroke: A systematic review. Gait Posture 2017; 54:133-143. [PMID: 28288334 DOI: 10.1016/j.gaitpost.2017.03.004] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 02/27/2017] [Accepted: 03/02/2017] [Indexed: 02/02/2023]
Abstract
Stroke commonly results in trunk impairments that are associated with decreased trunk coordination and limited trunk muscle strength. These impairments often result in biomechanical changes during walking. Additionally, the so-called pelvic step might be influenced by these impairments. Therefore, the aim of this review was twofold. First, to gain more insight into trunk biomechanics during walking in stroke patients compared to healthy individuals. Second, to investigate the influence of walking speed on trunk biomechanics. The search strategy was performed by the PRISMA guidelines and registered in the PROSPERO database (no. CRD42016035797). Databases MEDLINE, Web of Science, Cochrane Library, ScienceDirect, and Rehabdata were systematically searched until December 2016. Sixteen of the 1099 studies met the eligibility criteria and were included in this review. Risk of bias was assessed by the Newcastle-Ottawa Scale. The majority of studies reported on trunk kinematics during walking, data on trunk kinetics and muscle activity is lacking. Following stroke, patients walk with increased mediolateral trunk sway and larger sagittal motion of the lower trunk. Although rotation of the upper trunk is increased, the trunk shows a more in-phase coordination. Acceleration of the trunk diminishes while instability and asymmetry increase as there are less movement towards the paretic side. However, it is of great importance to differentiate between compensatory trunk movements and intrinsic trunk control deficits. Specific exercise programs, assistive devices and orthoses might be of help in controlling these deficits. Importantly, studies suggested that more natural trunk movements were observed when walking speed was increased.
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